Guy's & St Thomas' Hospital

ILD75

Acute kidney injury is very common amongst critically ill patients and mortality rates are high. It is not clear when renal replacement therapy (RRT - dialysis or transplantation) should start in patients who are critically ill with acute kidney injury (AKI). The STARRT-AKI trial examined the impact on patients' mortality and quality of life of early versus standard timing of starting RRT. NIHR funded an expanded UK arm to the STARRT-AKI trial to examine the cost-effectiveness of early versus standard timing of starting RRT in critically ill patients with AKI. As part of this evaluation, the study will use clinical and administrative data in the UK to understand the longer term impacts of the timing of RRT on patients. We will collect data on patients' quality of life and primary health and social care resource use at 3, 6 and 12 months. The data will be used to create a simulation model of patient costs and outcomes after severe acute kidney injury. Data from the UK Renal Registry will be used to estimate the likelihood of patients requiring long term dialysis or a kidney transplant in the simulation model. The model will estimate the long-term costs and outcomes of early vs standard timing of starting RRT in patients with AKI. RRT is expensive and patients usually require hospital admission. The information about long term kidney function is essential to inform commissioners and clinical guidelines on the best timing of RRT.

15/09/2020