Home About us Current issue Ahead of Print Back issues Submission Instructions Advertise Contact Login   

Search Article 
  
Advanced search 
 
Saudi Journal of Kidney Diseases and Transplantation
Users online: 6121 Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size 

ORIGINAL ARTICLE Table of Contents   
Year : 2017  |  Volume : 28  |  Issue : 6  |  Page : 1282-1292
A pragmatic randomized controlled trial comparing pathway-based versus usual care in community-acquired acute kidney injury


1 Department of Medicine, King Abdulaziz Medical City; Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
2 College of Nursing, King Saud Bin Abdulaziz University for Health Sciences; Department of Pharmaceutical Care, King Abdulaziz Medical City, Jeddah, Saudi Arabia
3 Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
4 Department of Medicine, King Saud Bin Abdulaziz University for Health Sciences; King Abdullah International Foundation for Dialysis, Jeddah, Saudi Arabia
5 King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
6 Department of Quality Management, King Abdulaziz Medical City, Jeddah, Saudi Arabia
7 Department of Nursing, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
8 Department of Epidemiology and Medical Statistics, University of Ibadan, Nigeria
9 Department of Medicine, National University of Medical Sciences, Rawalpindi, Pakistan

Correspondence Address:
Abdullah H Almalki
Department of Medicine, Nephrology Section, King Abdulaziz Medical City, P. O. Box 9515, Jeddah 21423
Saudi Arabia
Login to access the Email id


DOI: 10.4103/1319-2442.220872

PMID: 29265039

Rights and Permissions

Clinical pathways have shown conflicting evidence in improvement of several patient-centered outcomes across different clinical settings. However, the effectiveness of clinical pathway in management of acute kidney injury (AKI) has not been reported. Therefore, we aimed to assess the length of hospital stay (LOS) and patient-centered outcomes in community acquired AKI and compared pathway care (PC) versus usual care (UC). The CHAMP-Path AKI Trial is a pragmatic, parallel, single-blind randomized controlled trial. Physicians were randomized to provide either UC or PC. Patients were randomized through a computer-generated sequence. Allocation was concealed. Patients presenting to the emergency department with AKI and hemodynamic stability, who were over 14 years with a serum creatinine greater than 1.5 times the baseline were eligible. Patients with chronic kidney disease stages 4 or 5, kidney transplantation recipients, those admitted with obstructive uropathy, suspected glomerular or interstitial disease, and pregnant women were excluded. Thirty-eight patients were enrolled from March 2012 to December 2013. The primary outcome was LOS. Secondary outcomes included: 30-day readmission, in-hospital mortality, determinants of LOS, and patient-centered outcomes. Eighteen patients were randomized to PC, and 20 to UC. Baseline characteristics were comparable in both groups. Using an intention-to-treat analysis, the median LOS was 4.96 [interquartile range (IQR) 6.57] and 4.80 days (IQR 6.84) for PC and UC, respectively (P = 0.770). Of the five readmissions, none were for AKI. No in-hospital mortality was reported. The CHAMP-Path AKI pragmatic trial demonstrated that PC was not different than UC in reducing LOS. There was no difference in 30-day re- admission, in-hospital mortality, and patient-centered outcomes.


[FULL TEXT] [PDF]*
Print this article  Email this article
    

  Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
   Citation Manager
  Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2534    
    Printed19    
    Emailed0    
    PDF Downloaded277    
    Comments [Add]    

Recommend this journal