SP210THE IMPACT OF OBESITY ON RECOVERY FROM ACUTE KIDNEY INJURY: FEASIBILITY STUDY

INTRODUCTION AND AIMS: Acute kidney injury (AKI) is a rapid deterioration in kidney filtration rate or urine output, occurring in over 5% of hospital admission in the UK. AKI is associated with an increased risk of developing chronic kidney disease (CKD), resulting in an irreversible, and often progressive decline in kidney function. Obesity is also a risk factor for the development and worsening of CKD; however, the effect on recovery of kidney function after AKI, and the combined risk of obesity and AKI on subsequent development of CKD is not known. METHODS: A feasibility study was conducted to determine the feasibility of recruitment, retention and data collection procedures for the planned Ob-AKI cohort study in a sample of 100 patients hospitalised with an episode of AKI. Feasibility outcomes were monthly screening and recruitment uptake (more than 15% meeting inclusion criteria recruited), retention at 6 and 12 months (at least 80%), and completeness of data collection. Potential participants were identified by referral and electronic detection of episodes of AKI during their hospital admission, and recruited and consented whilst an inpatient or after discharge. Inclusion criteria were 18-85 years, episode of AKI (KDIGO 2012), and pre AKI creatinine measured within the previous 12 months. RESULTS: Screening and recruitment for a target of 100 patients was completed in 12 months in a single study centre; taking 6 months longer than planned. Electronic identification of AKI was not available for the first 9 months of recruitment. On average, 54 patients were screened each month, 27 added to the recruitment log, 19 were actually eligible and 7.5 consented to participate. 41% of eligible patients consented to participate in the study, far exceeding the feasibility target of 15%. 101 patients were recruited to the study (67M, 34F, mean age 63.5 (±12.6) years and mean BMI 29.9kg/m2 range 18.1 to 54.3kg/m2). 99 patients (98%) attended the baseline study visit (28.3% with stage I AKI, 21.2% stage 2 and 50.5% stage 3). At the baseline study visit, data were 100% complete for height, weight, blood pressure, reason for admission, diabetes and hypertension status, blood sampling and AKI staging including identifying the likely cause and classification as pre-renal renal or post-renal. Urine sampling was 96% complete and waist circumference was measured in 90% of patients. At 6 months, 85% (86/101) of patients remained in the study (7 withdrew, 4 died, 1 too unwell, 2 commenced HD), meeting the feasibility target for retention. CONCLUSIONS: Feasibility for recruitment and retention to a study addressing outcomes jointly associated with BMI and AKI has been demonstrated within a single centre, with a recruitment rate of 41% of eligible patients agreeing to participate in the study, and a high level of data completeness.

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