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AKINet Registration Form
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Postal Code
Phone number		Fax number
Main hospital	--------------------- University Non_University Teaching Community Military Other	Number of beds
Type of ICU	--------------------- Medical Surgical Med_surg Cardiac Other	Number of beds
Society Membership (please check all that apply) American College of Chest Physicians American Society of Nephrology American Society of Pediatric Nephrologists American Thoracic Society Asia Pacific Association of Critical Care Medicine, Asian Pacific Society of Nephrology Australian and New Zealand Intensive Care Society Chinese Society of Nephrology European Dialysis and Transplant Society European Society of Intensive Care Medicine Indian Society of Nephrology International Pediatric Nephrology Association International Society of Nephrology National Kidney Foundation Sociedade Latino-Americana de Nefrologia Area of clinical interest (check all that apply) Nephrology Intensive Care Cardiology Anesthesiology Other Area of research interest (check all that apply) Basic Science Translational Science Clinical trials Epidemiology How many patients do you have access to for clinical care with possible AKI? < 50 per year 50-100 per year > 100 per year How many patients do you have access to for research purposes with possible AKI? < 50 per year 50-100 per year > 100 per year Location of patients: (check all that apply) Out patient settings Hospital settings Critical Care settings If Critical Care setting: (check all that apply) Intensive Care Units Post-Operative surgical units Cardiac care units Do you have any of the following research related resources available to you: (check all that apply) Research Coordinators Research Infrastructure - Ethics Preparation Research Infrastructure - Methodologists Research Infrastructure - Statisticians Electronic Databases High capacity freezers for sample storage (-80 degrees C) Your expertise: (check all that apply) Clinical content Methodology - Basic Methodology - Clinical Critical Appraisal Uncertain Availability/Willingness to participate in consultations/meetings: Very available Somewhat Sometimes Rarely Not Available
Please check all that are yes.
Do you routinely perform urine analysis (including urine chemistries) when patients develop AKI? Do you routinely obtain a renal ultrasound when you diagnose AKI? Would you be able to obtain limited (one page) information on ALL patients admitted to your ICU during a 2 week period of your choosing (period must be consecutive)? Would you be able to provide hospital follow up information on all AKI cases (dialysis requirements, LOS, survival)? And obtain overall LOS and survival information for patients (mean data) for all patients treated in your ICU? Would you be able to obtain more detailed information (limited to 5 pages total) on the risk factors and etiology of AKI as well as its treatment? Disclaimer Please read and click "Submit" to complete your sign-up The information at this server is provided with the understanding that the publisher, authors, and advisors are not rendering medical or professional services. Medicine is a rapidly changing area, and efforts have been made to provide information that is medically correct at the time of initial posting. However, there may be mistakes, both typographical and in content, and subsequent findings may invalidate what is posted on this site. In portions of this site, comments are made by persons identified as physicians or allied professionals. No attempt has been made to verify the medical credentials of persons contributing to discussions or talks. Typographical errors are common in slides, and one should not rely on drug dosages listed either in the slides, transcripts, or posted abstracts without first verifying them from manufacturer-supplied product information. The material provided should be used only as a general guide and not the ultimate source of information and should not be used to make personal or professional decisions. The authors, advisors, and publisher shall have neither liability not responsibility to any person or entity with respect to any loss or damage alleged to be caused directly or indirectly by the information presented in this journal/server. (Press the "Submit" button to complete your sign-up) Press this only if you agree with the above