Research Groups

RAPNet

Name: Renal Protection Network, short RAPNET

 

Background

In order to improve renal outcome in the perioperative period a selection of preclinical and clinical investigator would like to establish the RAPNet to perform multicenter clinical studies, randomized controlled trials and meta-analyses related to kidney protection during general anesthesia for surgery and in the ICU.

 

Objective

The RAPNet aims to find and test which severity (moderate to severe) and type of AKI (oliguric and/or azotemic) has an impact on patients outcome and which renoprotective strategies are the best for the good health of kidneys in critically ill patients undergoing surgery.  

 

Futhermore RAPNet aims at becoming a training network, offering transnational and inter-sectoral training for young researchers in the field of renal physiology, biology and renal support techniques in the operating room and on the intensive care unit. These future researchers will be trained in their roles as coordinators of laboratory studies and international multicenter observational studies and randomized controlled clinical trials in the near future.  

 

Missions

The goals of the RAPNet for the next 5 years are to design and conduct observational studies and clinical trials that focus on strategies that could prevent or decrease the development of AKI.

 

Specifically, the RAPNET will conduct several studies. Among others there are PrevAKI” (PREVention of Acute Kidney Injury), which is a randomized controlled trial that compares a standard care therapy with the implementation of a bundle of supportive measure in high risk patients “INARO” (INcidence of AKI and the Relevance of Oliguria in the perioperative period), which is an international observational study on the epidemiology of perioperative AKI and the relevance of the severity and type of AKI on the outcome of surgical patients. “EPIS-AKI” (EPIdemiology of Surgical-induced Acute Kidney Injury In the upcoming years, RAPNet will test also novel renoprectective strategies and novel diagnostic approaches towards real time monitoring and evaluation.

 

EPIS-AKI

Observational study to evaluate the EPIdemiology of Surgical-induced Acute Kidney Injury

Objectives

Primary

  • Occurrence of AKI within 72h after surgery according the KDIGO criteria 

 

Secondary

  • Effect of preoperative risk factors on the incidence of post–operative AKI 
  • Effect of predetermined intraoperative factors on the incidence of post–operative AKI 
  • Biomarkers of AKI (urine for this endpoint will be collected in some centers) 
  • Outcomes: 

o   Use of renal replacement therapy 

o   Length of ICU stay 

o   Length of hospital stay 

  • Survival 

o   ICU mortality 

o   Hospital mortality 

  • MAKE90 (major adverse kidney events at day 90): combined endpoint consisting of: 

o   mortality 

o   renal replacement therapy 

o  persistent renal dysfunction defined as serum-creatinine ≥ 1.5 times as compared to baseline serum-creatinine

Study design

EPIS-AKI is an international multi-center, prospective observational study with the aim to include 10,000 patients in total to clarify the incidence and circumstances of the occurrence of acute kidney injury in patients undergoing major surgery.


Inclusion criteria

  • Age ≥ 18 years
  • Major surgeries with a duration of at least 2 h
  • Planned or unplanned admission to the ICU, IMC or PACU after surgery
  • Written informed consent

Exclusion criteria

  • Pre-existing AKI
  • AKI within the last 3 months
  • End stage renal disease with dialysis dependency
  • Kidney transplant

Website EPIS-AKI

Under construction

Contact

Alexander Zarbock (University Hospital Münster)                   zarbock@uni-muenster.de

Raphael Weiss (University Hospital Münster)                           Raphael.Weiss@ukmuenster.de