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Acute Kidney InjuryCOPE-AKINCT05805709

A Patient-centered Trial of a Process-of-care Intervention in Hospitalized AKI Patients: the COPE-AKI Trial

A study testing Study Physician/Advance Practice Provider, Nurse Navigator and Pharmacist in people with Acute Kidney Injury, run by University of Pittsburgh at 9 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The COPE-AKI study is a randomized, pragmatic, parallel-arm trial comparing a multimodal intervention to usual care on hospital-free days through 90 days of study follow up. The primary study hypothesis is that patients randomized to the intervention will have increased odds of more hospital-free days through 90 days… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Acute Kidney Injury
What is being tested?
Study Physician/Advance Practice Provider, Nurse Navigator and Pharmacist
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,145 participants
Where
9 sitesUnited States
Study dates
5 Sep 2023to 30 Nov 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Aged ≥ 18 years
  • Kidney Disease Improving Global Outcomes (KDIGO) Stage 2/3 AKI with evidence of persistent AKI (defined as meeting Stage 2+ AKI for 2 consecutive days with serum creatinine concentration measurements >12 hours apart)

Who cannot join

  • AKI due to primary glomerulonephritis, renal vasculitis, or thrombotic microangiopathy
  • Diagnosis of end-stage kidney disease (ESKD) at the time of admission, defined as:
  • Baseline estimated glomerular filtration rate (eGFR) <15 mL/min/1.73m2
  • Previous kidney transplant recipient
  • On chronic dialysis
  • Acute urinary obstruction with rapid kidney function improvement following relief of obstruction
Show all 29Show fewer
  • Index hospitalization involving nephrectomy
  • Index hospitalization involving solid organ transplant or stem cell/bone marrow transplant
  • Continued dialysis dependence at time of discharge
  • Previous (within 6 months) or new referral to a nephrologist for care specifically for:
  • Previous or new diagnosis of glomerulonephritis
  • Primary electrolyte imbalance disorders unrelated to AKI (e.g., syndrome of inappropriate antidiuretic hormone secretion, Bartter syndrome)
  • Active treatment for acute interstitial nephritis
  • Non-kidney end-organ failure:
  • Class IV congestive heart failure
  • Decompensated cirrhosis with Model For End-Stage Liver Disease (MELD) > 30 or those with a diagnosis of hepatorenal syndrome by the clinical teams
  • End-stage pulmonary disease (advanced stage chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, pulmonary hypertension)
  • Metastatic malignancy or malignancy requiring active treatment (chemotherapy, immunotherapy), such as multiple myeloma
  • Primary goal of care is palliation: life expectancy <6 months
  • Pregnancy
  • Vulnerable populations
  • Persons incarcerated
  • Persons institutionalized
  • Inability to provide informed consent
  • Impaired cognition as demonstrated by the Brief Confusion Assessment Method (bCAM)
  • Concurrent enrollment in a separate greater than minimal risk interventional trial
  • Inability to participate in either in-person or remote visits
  • Inability to participate as determined by the research team at time of discharge based on disposition (vs uniform decision across site about exclusion based on SNF)
  • Discharge to long-term acute care facility or other hospital-based location

Trial locations and contacts

9 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Susan J Copelli, MSHI contact

412-245-0803

sju1@pitt.edu

Kaleab Abebe, PhD contact

kza3@pitt.edu

9 sites in 1 country

United States9 sites, 9 recruiting
  • University of Maryland

    Baltimore, Maryland, 21201

    Tramanh Phan, MD, TPhan@som.umaryland.edu

    Matthew Weir, MD

    Recruiting
  • Johns Hopkins University

    Baltimore, Maryland, 21287

    Pam Corona, MD, pamelacorona@jhmi.edu

    Chirag Parikh, MD PhD

    Recruiting
  • University of Alabama at Birmingham

    Birmingham, Alabama, 35233

    Patricia Busta

    Javier Neyra, MD

    Recruiting
  • MetroHealth

    Cleveland, Ohio, 44109

    Kyra Jancik, KJancik@metrohealth.org

    Edward Horwitz, MD

    Recruiting
  • Cleveland Clinic Foundation

    Cleveland, Ohio, 44195

    Savannah Gagnon, BS

    Emilio Poggio, MD

    Recruiting
  • Nashville VA Medical Center

    Nashville, Tennessee, 37212-2637

    Jasiu Latocha, john.latocha@vumc.org

    Eddie Siew, MD

    Recruiting
  • Vanderbilt University

    Nashville, Tennessee, 37232

    Ethan Kefauver, BS, ethan.kefauver@vumc.org

    Edward Siew, MD

    Recruiting
  • Yale University

    New Haven, Connecticut, 06510

    Angela V Castro, MD, angela.victoria-castro@yale.edu

    Francis Wilson, MD

    Recruiting
  • Cleveland Clinic Weston Hospital

    Weston, Florida, 33331

    Laura Duarte, DUARTEL2@ccf.org

    Scott Cohen, MD

    Recruiting

Other trials in United States

About this study

Official title: Caring for OutPatiEnts After Acute Kidney Injury (COPE-AKI) Trial

The COPE-AKI study is a randomized, pragmatic, parallel-arm trial comparing a multimodal intervention to usual care on hospital-free days through 90 days of study follow up. The primary study hypothesis is that patients randomized to the intervention will have increased odds of more hospital-free days through 90 days (primary clinical) compared to those randomized to usual care. Key secondary hypotheses will investigate the impact of the intervention on rates of major adverse kidney events, rates of recurrent AKI, and changes in patient-reported outcomes. Participants (N=2145) will be allocated 1:1 to the intervention or usual care using a web-based system to maintain allocation concealment using stratified randomization with randomly permuted blocks. Randomization will be stratified by clinical site.

Read the detailed description

The primary study hypotheses for the COPE-AKI study are: compared to usual care, patients randomized to a multimodal intervention will have increased odds of more hospital-free days through 90 days (primary) and lower rates of major adverse kidney events (MAKE) at 180 days, lower rates of recurrent AKI at 180 days, and greater improvements in patient-reported outcomes over 90 days (secondary).

The primary outcome is hospital-free days through 90 days of follow up, defined as 90 minus the number of calendar days in the hospital as either an inpatient or on observation status, based on the determination made by the corresponding hospital. Key secondary outcomes include: rates of MAKE (measured at 90, 180, and 365 days), rates of recurrent AKI (90, 180, and 365 days), and 4 patient-report outcomes: global health related quality of life, AKI-specific health related quality of life, provider interactions, and social support (30, 90, 180, 365 days).

A multimodal process-of-care intervention that includes 1) study physician oversight and follow up care recommendations at the time of hospital discharge; 2) involvement of a nurse navigator to provide kidney-disease related education, coordinate care, and assess symptoms; and 3) pharmacist-led medication reconciliation and review. Participants in the usual care arm will be provided information about their kidney disease, nephrotoxins to be avoided, and the importance of follow up with a physician will be emphasized.

Being tested
Study Physician/Advance Practice Provider, Nurse Navigator, Pharmacist, Patient Education
Keywords
acute kidney injury, process of care, acute renal failure, kidney failure, kidney damage, pragmatic, nurse navigator, pharmacist
Medical subject headings
Acute Kidney Injury, Renal Insufficiency

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Study Physician/Advance Practice ProviderOther

    The nephrologist and/or nephrology-associated advanced practice provider (APP) at each site will lead the intervention team for the duration of the study. The study physicians will fulfil two main roles: (a) Provide supervision to the rest of the study team and (b) conduct a discharge assessment to triage and make recommendations for follow-up care.

  • Nurse NavigatorOther

    The nurse navigator will be the primary contact for the participants assigned to the intervention group for the study. The navigator will obtain contact information, information about the patient's usual care providers and pharmacy, review medications, show the participant how to use the home blood pressure machine and scales and arrange for follow-up visits. The role of the nurse navigator will be to monitor the participant's medical condition; facilitate scheduling of needed medical follow-up including both routine (pre-scheduled) and ad hoc (urgent or emergency); enhance adherence with prescribed medical care and follow-up appointments; and serve as a resource to the patient to answer questions about their AKI-related management, facilitate medical and associated care and provide enhanced psychosocial support.

  • PharmacistOther

    The pharmacist will complete the medication reconciliation and medication regimen review per the predetermined checklist, via telemedicine if agreeable to the patient. The goal of the patient/caregiver-pharmacist interaction is to cover the following: avoidance of nephrotoxins when possible and appropriate, appropriate dosing of renally cleared drugs, review for drug-drug interactions, monitoring appropriate use of chronic medications, medication adherence, monitor for adverse drug reactions, evaluation of non-prescription medication use, medication/disease education and social support.

  • Patient EducationOther

    Written information about kidney disease, nephrotoxins to be avoided and importance/need for follow up with a physician will be provided.

Study groups in NCT05805709
Study groupRoleWhat they receive
Multimodal Process of Care InterventionExperimentalA multimodal process-of-care intervention that includes 1) study physician oversight and follow up care recommendations at the time of hospital discharge; 2) involvement of a nurse navigator to provide kidney-disease related education, coordinate care, and assess symptoms; and 3) pharmacist-led medication reconciliation and review.
Receives: Other: Study Physician/Advance Practice Provider; Other: Nurse Navigator; Other: Pharmacist; Other: Patient Education
Usual CareActive comparatorAfter receiving the same written information about kidney disease, nephrotoxins to be avoided and importance/need for follow up with a physician as individuals randomized to the multimodal intervention arm, participants randomized to the control arm will receive usual care as specified by their treating providers and will not be followed by nurse navigator, pharmacist, or the study team. The only subsequent study-related activities will be the follow-up study visits for ascertainment of endpoints with the research coordinator.
Receives: Other: Patient Education

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Hospital-Free Days (HFDs) through day 90

    Hospital-free days through day 90 defined as 90 minus the number of calendar days in the hospital as either an inpatient or on observation status.

    Measured: 90 days

Secondary outcomes (6)
  1. Rate of Major Adverse Kidney Events (MAKE) at 180 days

    MAKE-180 composite outcome of death, dialysis and assessment of kidney function defined as:

    • death within 180 days of index hospital discharge;
    • need for dialysis at 180 days after index hospital discharge; or
    • serum creatinine >2x baseline at 180 days after index hospital discharge

    Measured: 180 days

  2. Recurrent Acute Kidney Injury (AKI) Hospitalization at 180 days

    Episodes of recurrent AKI during subsequent all-cause hospitalizations will be adjudicated based on hospitalization data, defining recurrent episodes of AKI based on an increase in serum creatinine of >50% relative to the lowest-known value preceding or including the rehospitalization.

    Measured: 180 days

  3. Change from baseline in Global Health-Related Quality of Life (HR-QoL) at 90 days.

    HR-QOL will be assessed with the 10-item Patient-Reported Outcomes Measurement Information System (PROMIS) HRQoL measure. The PROMIS Global Health measures assess an individual's physical, mental, and social health. The measures are generic, rather than disease-specific, and often use an "In General" item context as it is intended to globally reflect individuals' assessment of their health. The adult PROMIS Global Health measure produces two scores: Physical Health and Mental Health, which are rescaled into a standardized score (T-score) with a mean of 50 and a standard deviation (SD) of 10. Therefore a person with a T-score of 40 is one SD below the mean. A higher T-score represents more of the concept being measured. Thus, a person who has T-scores of 60 for the Global Physical Health or Global Mental Health scales is one standard deviation better (more healthy) than the general population.

    Measured: 90 days

  4. Change from baseline in AKI-Specific Health-Related Quality of Life (HR-QoL) at 90 days.

    AKI-Specific HR-QOL will be assessed with the 6-item Chronic Kidney Disease Quality of Life (CKD-QoL) measure. The CKD-QoL comprehensively represents CKD-specific quality of life and yields a single summary impact score. Norm-based scoring is used (linearly transformed to have a mean of 50 and an SD of 10) in which a higher score indicates worse QOL impact.

    Measured: 90 days

  5. Change from baseline in Interactions with Providers at 90 days.

    Provider interactions will be assessed with the 5-item Perceived Efficacy in Patient-Physician Interactions (PEPPI) and 8-item Client Satisfaction Questionnaire (CSQ-8) measures. The PEPPI provides a summary score ranging for 5 to 25 (25 = sighted patient self-efficacy). The CSQ-8 is a structured survey used to assess level of satisfaction with care. Items are scored on a Likert scale from 1 (low satisfaction) to 4 (high satisfaction) with different descriptors for each response point. Total scores range from 8 to 32, with higher scores indicating greater satisfaction.

    Measured: 90 days

  6. Change from baseline in Social Support at 90 days.

    Social support will be assessed with the 4-item PROMIS Emotional Support and 4-item PROMIS Instrumental Support short forms. The Emotional Support and Instrumental Support measures each produce a summary score, which are rescaled into a standardized score (T-score) with a mean of 50 and a standard deviation (SD) of 10. Therefore a person with a T-score of 40 is one SD below the mean. A higher T-score represents more of the concept being measured. Thus, a person who has a T-score of 60 is one standard deviation better (more healthy) than the general population.

    Measured: 90 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Apr 2023
  2. Study start5 Sep 2023
  3. Primary completion28 Feb 2028 (estimated)
  4. Study completion30 Nov 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a randomized, pragmatic, parallel-arm kidney trial conducted to find out if an "enhanced care" team approach can improve a patient's outcomes after hospitalization with acute kidney injury (AKI). Participants (N=2145) will be allocated 1:1 to the intervention or usual care using a web-based system to maintain allocation concealment using stratified randomization with randomly permuted blocks. Randomization will be stratified by clinical site.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
2,145 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05805709
Sponsor's protocol ID
STUDY21080024
Other IDs
1U01DK130010, 1U01DK129989, 1U01DK129980, 1U01DK129984
Acronym
COPE-AKI
Status last verified
Sep 2026
First submitted
23 Feb 2023
Last updated
25 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Study participant research data, which is for purposes of statistical analysis and scientific reporting, will be transmitted to and stored at the University of Pittsburgh Data Coordinating Center (DCC). This will not include the participant's contact or identifying information. Rather, individual participants and their research data will be identified by a unique study identification number. The study data entry and study management systems used by clinical sites and by the DCC research staff will be secured and password protected. At the end of the study, all study databases will be de-identified and archived at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Central Repository.

Questions about this trial

What is this clinical trial studying?

A study testing Study Physician/Advance Practice Provider, Nurse Navigator and Pharmacist in people with Acute Kidney Injury, run by University of Pittsburgh at 9 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 29 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 25 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Susan J Copelli, MSHI (412-245-0803, sju1@pitt.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hospital-Free Days (HFDs) through day 90 (time frame: 90 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Sep 2026.

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