There are approximately 300 CT head scans ordered from the Emergency Department (ED) at Royal Infirmary of Edinburgh per month; many of which indicate that there is no significant injury.
A blood-based brain biomarker test that can predict presence or absence of a brain injury and its severity would support clinical decision making and reduce the need for CT scans, streamline clinical management, reducing costs and cranial exposure to radiation. In this study blood samples will be collected from participants for whom the assessing clinician has identified a clinical need to undergo CT brain imaging after a TBI, and where patients have given consent to participate in the NHS Lothian Biobank. Blood samples will be anlaysed using infrared spectroscopy, or other assays targeted at TBI assessment. Our aim is to ascertain whether the severity and likely clinical course of a head injury can be accurately predicted at the time of admission.
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.