To improve renal outcome in the perioperative period, a selection of preclinical and clinical investigator would like to establish the RAPNet to perform multi-centre clinical studies, randomized controlled trials and meta-analyses related to kidney protection during general anaesthesia for surgery and in the ICU.
The RAPNet aims to find and test which severity (moderate to severe), and type of AKI (oliguric or azotemic) has an impact on patients outcome and which renoprotective strategies are the best for the excellent health of kidneys in critically ill patients undergoing surgery.
Furthermore, 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 multi-centre observational studies and randomized controlled clinical trials soon.
The goals of the RAPNet for the next five 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 also test novel renoprotective strategies and novel diagnostic approaches towards real-time monitoring and evaluation.
Observational study to evaluate the EPIdemiology of Surgical-induced Acute Kidney Injury
- The occurrence of AKI within 72h after surgery according to the KDIGO criteria
- Effect of preoperative risk factors on the incidence of postoperative AKI
- Effect of predetermined intraoperative factors on the impact of postoperative AKI
- Biomarkers of AKI (urine for this endpoint will be collected in some centres)
- Use of renal replacement therapy
- Length of ICU stay
- Length of hospital stay
- ICU mortality
- Hospital mortality
- MAKE90 (major adverse kidney events at day 90): combined endpoint consisting of:
- renal replacement therapy
- persistent renal dysfunction defined as serum-creatinine ≥ 1.5 times as compared to baseline serum-creatinine
EPIS-AKI is an international multi-centre, prospective observational study 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.
- Age ≥ 18 years
- Major operations with a duration of at least two hours
- Planned or unplanned admission to the ICU, IMC or PACU after surgery
- Written informed consent
- Pre-existing AKI
- AKI within the last three months
- End-stage renal disease with dialysis dependency
- Kidney transplant
Alexander Zarbock (University Hospital Münster) firstname.lastname@example.org
Raphael Weiss (University Hospital Münster) Raphael.Weiss@ukmuenster.de