We would like to collect and test samples from people with cirrhosis who are admitted to our unit to search for new biomarkers of kidney damage and to see if there are differences in these biomarkers between patients who recover fully and those who do not. We hope that this research will lead to a better test for kidney damage that might improve outcomes for people with cirrhosis.
We are undertaking a research study to identify substances that are released into the blood or urine when the kidney is damaged in people with cirrhosis. These substances (so called ‘biomarkers’) might enable us to detect kidney damage more quickly so that appropriate treatment can be started promptly. Acute kidney injury (AKI) is a common and under-diagnosed problem in patients with liver cirrhosis, and is associated with significant illness and preventable death. Blood (serum) creatinine is the current test for kidney function, but it is an insensitive and non-specific marker in cirrhosis. We hypothesise that blood (plasma) levels of kidney injury molecule-1 (KIM-1) will detect AKI earlier and predict the risk of worsening AKI in cirrhosis, thus identifying patients in need of prompt and effective treatment and improving patient outcomes. We will collect blood and urine samples from cirrhosis patients admitted into hospital and study the relationship between plasma KIM-1, other diagnostic ‘biomarker’ tests that have recently been proposed, and patient outcomes.
Attitudes towards Research and Research Nurses among the clinical team in an Emergency Department (ED) and Acute Medical Unit (AMU)
Attitudes towards Research and Research Nurses
ETNA: Edinburgh Transient and Neurological attack: A Cohort Study
Patients frequently present with minor neurological symptoms where a diagnosis of transient ischaemic attack (TIA) or minor stroke is difficult to make positively or to exclude reasonably. For these patients, clinicians are uncertain whether they should: (a) reassure most patients that their symptoms are benign; (b) treat most patients with antiplatelet or other vascular prevention; or (c) stratify stroke risk further using clinical features or brain imaging.
This is important because clinical diagnosis is difficult. Mis-diagnosis is not infrequent and leads to harm from preventable recurrent stroke and costs to health systems from extra care and legal liabilities.
All ETNA participants will receive an MRI scan and the study aims to establish the feasibility and methods for a larger study of diagnostic utility of MR brain imaging and estimate the effects of MRI on clinician decision making.
This study has been recruiting in the Emergency Dept, inpatient wards and TIA clinics since August 2018. We aim to recruit 270 participants and have almost reached our target!