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Vitamin D levels in critically ill patients with acute kidney injury: A protocol for a prospective cohort study (VID-AKI)

Cameron, L.K., Lei, K., Smith, S., Doyle, N.L., Doyle, J.F., Flynn, K., Purchase, N., Smith, J., Chan, K., Kamara, F. , Kidane, N.G., Forni, Lui G., Harrington, D., Hampson, G. and Ostermann, M. (2017) Vitamin D levels in critically ill patients with acute kidney injury: A protocol for a prospective cohort study (VID-AKI) BMJ Open, 7 (7), 016486.

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Abstract


Introduction

Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality. The primary objective of this study is to perform serial measurements of 25(OH)D and calcitriol (1,25(OH)2D), as well as parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) levels, in critically ill adult patients with and without AKI, and to determine whether patients with AKI have significantly lower vitamin D metabolite concentrations. The secondary objectives are to describe dynamic changes in vitamin D metabolites, PTH and FGF23 during critical illness; to compare vitamin D metabolite concentrations in patients with AKI with and without renal replacement therapy; and to investigate whether there is an association between vitamin D status and outcomes.


Methods and analysis

230 general adult intensive care patients will be recruited. The AKI arm will include 115 critically ill patients with AKI Kidney Disease Improving Global Outcome stage II or stage III. The comparison group will include 115 patients who require cardiovascular or respiratory support, but who do not have AKI. Serial measurements of vitamin D metabolites and associated hormones will be taken on prespecified days. Patients will be recruited from two large teaching Trusts in England. Data will be analysed using standard statistical methods.


Ethics and dissemination

Ethical approval was obtained. Upon completion, the study team will submit the study report for publication in a peer-reviewed scientific journal and for conference presentation.


Trial registration number NCT02869919; Pre-results.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Cameron, L.K.
Lei, K.
Smith, S.
Doyle, N.L.
Doyle, J.F.
Flynn, K.
Purchase, N.
Smith, J.
Chan, K.
Kamara, F.
Kidane, N.G.
Forni, Lui G.l.forni@surrey.ac.uk
Harrington, D.
Hampson, G.
Ostermann, M.
Date : 12 July 2017
DOI : 10.1136/bmjopen-2017-016486
Copyright Disclaimer : Copyright information © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Depositing User : Diane Maxfield
Date Deposited : 24 Oct 2019 13:48
Last Modified : 24 Oct 2019 13:48
URI: http://epubs.surrey.ac.uk/id/eprint/852726

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