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.
1. Ambulatory Device, Rocket Pleural vent insertion
2. Standard Treatment, Aspiration +/- chest drain
Primary Outcome Measures
To assess whether use of an ambulatory device (Rocket Pleural Vent) and treatment strategy reduces hospital stay. Total length of stay in hospital up to 30 days post randomisation. Up to 30 days post randomisation.
RAMPP trial - Randomised Controlled Trial: Pleural vent (rocket) V standard care in Primary Spontaneous Pnuemothorax
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