early amino acid treatment to prevent kidney injury in critically ill patients with sepsis in the ICU

INTERVENTION: Intervention1: Early intravenous amino acid infusion: Early intravenous amino acid infusion started within 24 hours of diagnosis of sepsis in addition to standard care. Intravenous amino acid solution will be administered as per study protocol for prevention of sepsis associated acute kidney injury Control Intervention1: standard care: patient in control group receive standard care in ICU CONDITION: Health Condition 1: A30‐A49‐ Other bacterial diseases PRIMARY OUTCOME: To determine whether early intravenous amino acid infusion reduces incidence of SA‐AKI within 7 days in critically ill septic patients (sepsis 3 + KDIGO)Timepoint: To determine whether early intravenous amino acid infusion reduces incidence of SA‐AKI within 7 days in critically ill septic patients (sepsis 3 + KDIGO) SECONDARY OUTCOME: Change in renal resistive indexTimepoint: baseline, 24 hours, 48 hours Change in serum NGAL levelsTimepoint: baseline, 24 hours, 48 hours ICU mortalityTimepoint: during ICU stay Major adverse kidney eventsTimepoint: at 30 days or at the time of discharge Requirement of renal replacement therapyTimepoint: Within 30 days of enrollment INCLUSION CRITERIA: Adult patients aged 18 years and above Patients admitted to ICU with sepsis or septic shock Expected ICU stay more than 48 hours Patients at high risk of acute kidney injury Requirement of vasopressor support Serum lactate more than 2 mmol/L Written informed consent from patient or legally acceptable representative