What the trial was testing
The ACORN enrolled 2,634 patients with kidney disease. The study was sponsored by Vanderbilt University Medical Center and tracked outcomes across the full group of patients who matched the trial's eligibility profile.
It was long-term safety (phase 4). Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.
What the results showed
Patients on cefepime had fewer days alert and clear-headed than those on piperacillin-tazobactam.
JAMA · 2023 · NCT05094154
These findings — that cefepime patients had slightly fewer days without confusion or coma — were published in the JAMA and represent the headline result of the study.
Researchers tracked outcomes across 2,634 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.
What this means for patients
For patients with kidney disease, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.
What you can do now
Both antibiotics are FDA-approved and widely used in hospitals. This study suggests piperacillin-tazobactam may be a safer choice for preventing confusion and delirium. If you're hospitalized and need these antibiotics, talk to your doctor about which one is best for you.
Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.
Open kidney disease trials
A Study of ONO-3310 in Healthy Adult Male Subjects and Chronic Kidney Disease Patients With Type 2 Diabetes Mellitus
To investigate the safety, tolerability, pharmacokinetics, and pharmacodynamics of single and multiple oral doses of ONO-3310 in healthy Japanese adult male subjects and chronic kidney disease patients with type 2 diabetes mellitus
CBCT Guided Markerless SBRT for Renal Cell Cancer
This study aims to improve the treatment of kidney tumors using radiotherapy, by investigating whether kidney cancer can be more effectively irradiated with the help of new imaging techniques