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UPTAKE: Using Personalized Risk and Digital Tools to Guide Transitions Following Acute Kidney Events

Acute Kidney Injury

Nearly one in ten people who are hospitalized in Canada develop a complication with sudden loss of kidney function, called acute kidney injury (AKI). AKI may lead to other severe health problems after discharge home, such as kidney failure requiring dialysis treatment, heart failure, heart attacks, stroke, and even premature death. Discharge from hospital to home can be a difficult transition where there are often gaps in identification, communication, care coordination, education, and planning of care for AKI. The study team will co-design and evaluate a tailored post-discharge care plan that is based on the risk of later kidney problems and uses currently available, yet untapped digital innovation to improve the health and experience of people with AKI.

This study will be built into Alberta's new Epic Systems based provincial electronic health record (EHR). The plan is to use digital tools in the EHR to identify all people in Alberta hospitals that have had an AKI event and are at increased risk of long-term complications. Half will randomly be assigned to receive a tailored care plan based on their risk at hospital discharge while the other half will receive care as it is currently provided by their healthcare team. The electronic health system will automatically calculate a patient's risk and report this risk in their chart along with recommendations for care. The study team includes patients, healthcare providers, and health system decision makers needed to co-develop the proposed strategy and introduce the changes needed to deliver this intervention. The investigators will study whether this strategy can reduce health problems that may happen after AKI including death, chronic kidney disease (CKD), kidney failure, heart attacks, and stroke. The investigators will also determine if the approach improves patient experience during the transition from hospital to home. This study has the potential to revolutionize how we care for people that leave hospital after having AKI.

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Participation Requirements

  • Sex:

    ALL

  • Eligible Ages:

    18 and up

Participation Criteria

Inclusion Criteria:

(all of)

* Age ≥ 18 years old
* Hospitalized at site using AHS EHR
* Acute Kidney Injury (Stage 1-3) identified in hospital per KDIGO guideline criteria

Exclusion Criteria:

(any of)

* Pre-hospitalization advanced CKD: eGFR\<30 mL/min/1.73m2
* Pre-hospitalization dialysis
* Very low risk (\<1% risk) of advanced CKD
* Non-Alberta resident
* Palliative goals of care
* Enrolled in the UPTAKE VC Trial
* Admitted under a nephrologist at time of discharge
* Dialysis on at least 2 days in the last week prior to discharge
* Receiving apheresis
* Kidney transplant recipient
* Diagnosis of Glomerulonephritis
* Cirrhosis AND complication of cirrhosis in medical history or active problem list (ascites, varices, hepatic encephalopathy, hepatorenal syndrome)

Study Location

University of Alberta Hospital
University of Alberta Hospital
Edmonton, Alberta
Canada

Contact Study Team

Primary Contact

Neesh Pannu

[email protected]
Foothills Medical Centre
Foothills Medical Centre
Calgary, Alberta
Canada

Contact Study Team

Primary Contact

Matt James

[email protected]
Study Sponsored By
University of Alberta
Participants Required
More Information
Study ID: NCT05806645