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ProGReSS AKI: Protocolized Goal-directed Resuscitation of Septic Shock to Prevent AKI

PI: John A. Kellum, MD

Co-PI: Lakhmir Chawla, MD; Kai Singbartl, MD

Co-Investigators: Derek C. Angus, MD, Raghavan Murugan, MD, Lan Kong, PhD, Paul Palevsky, MD, Sachin Yende, MD and Xiaoyan Wen, MD

Funding: NIH R01DK083961 (Project period: 7/15/10 to 6/30/14)

Sepsis is a clinical syndrome arising from the systemic host response to infection. Sepsis results in intense inflammation initially intended to control and eliminate infection, but may also precipitate organ dysfunction. Septic shock, sepsis-induced hypotension persisting despite adequate fluid resuscitation, affects nearly a million Americans each year, a third of whom die. The kidney is one of the most common organs to be affected by severe sepsis, and sepsis is the leading cause of AKI. Few treatment options are available to clinicians seeking to prevent or reduce injury to the kidney in the setting of septic shock. Resuscitation with fluids and vasopressors is perhaps the only available strategy to address sepsis-induced AKI and is the subject of ProCESS.

The central goal of ProGReSS AKI is to examine the effect of protocolized resuscitation on the development of AKI. We also seek to explore mechanisms underlying the effect of the intervention and to evaluate markers of renal injury and repair in order to help select patients for future interventional trials. In keeping with the NIH roadmap, in order to understand the clinical utility of this work, we will build a clinical risk prediction model that will consider biomarkers and clinical variables.