Identifying Neurocognitive Outcomes and Cerebral Oxygenation in Critically Ill Adults on Acute Kidney Replacement Therapy in the Intensive Care Unit

What this Trial Is About

This research aims to understand brain oxygen levels and their link to long-term thinking and functional outcomes in adults who are critically ill with acute kidney injury (AKI) and need kidney replacement therapy (KRT) in the intensive care unit (ICU). Patients starting dialysis in the ICU may face risks of brain problems, including delirium and cognitive impairment, which affect quality of life and healthcare use. The study is observational and focuses on cerebral oxygenation as an early marker for these outcomes. Participants will undergo monitoring of cerebral oxygen saturation using near infrared spectroscopy with the FORESIGHT Elite cerebral oximeter during the first 72 hours of their critical illness and during dialysis treatments. The study includes patients receiving either intermittent hemodialysis or continuous kidney replacement therapy within 12 hours of starting treatment. Various tests will be done to assess brain function, including structural brain imaging with MRI and neurocognitive testing at 3 and 12 months after hospital discharge. Throughout the ICU stay, delirium will be checked daily using the Confusion Assessment Method for the ICU (CAM-ICU) and severity scored with CAM-ICU-7. Follow-up assessments at 3 and 12 months will measure neurocognitive function, medication adherence, driving safety, and healthcare use. The study lasts at least one year post-discharge to evaluate the long-term impact on brain health and daily function.

Neurocognitive Outcomes for ICU Patients With Acute Kidney Injury