Effects of Levosimendan in Acute Kidney Injury After Cardiac Surgery (LEVOAKI)
Acute kidney injury (AKI) is a common complication after cardiac surgery. Mismatch in renal oxygen demand-supply may be an important pathogenetic factor. Levosimendan has been shown to improve renal blood flow, glomerular filtration rate and renal oxygenation in healthy controls after cardiac surgery.
In order to investigate the effect of levosimendan in patients with AKI after cardiac surgery, the investigators plan a randomized placebo controlled trial. 30 patients will receive levosimendan or placebo. Renal blood flow and filtration fraction will be measured using infusion clearance technique of para-aminohippuric acid and Chromium ethylenediaminetetraacetic acid (Cr-EDTA) respectively.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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-
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Gothenburg, Sweden, 41345
- Department of thoracic anesthesia, Sahlgrenska University Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients in the cardiothoracic intensive care after cardiac surgery with cardiopulmonary bypass
- Acute kidney injury, defined as increase in S-creatinine 50% or 27 mol/L
- Normal S-creatinine before surgery
Exclusion Criteria:
- Ongoing treatment with inotropic drugs (not norepinephrine)
- Central venous oxygen saturation (ScvO2) < 60% despite optimization of hematocrit and volume status
- Need of renal replacement therapy
- Ongoing bleeding
- Patient or next of kin does not consent with study participation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: TRIPLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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ACTIVE_COMPARATOR: Levosimendan
Levosimendan will be given as a loading dose of 12 ug/kg during 30 minutes, and then a continuous infusion of 0,1 ug/kg/min for 180 minutes.
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Other Names:
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PLACEBO_COMPARATOR: Placebo
Sodium chloride will be given as a loading dose during 30 minutes and then a continuous infusion for 180 minutes at a rate mimicking the levosimendan group above.
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Sodium chloride
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Renal blood flow
Time Frame: 5 Hours
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Renal blood flow will be measured using infusion clearance technique of para-aminohippuric acid.
Measurements will be made in duplicates before and after administration of the study drug.
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5 Hours
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Glomerular filtration rate
Time Frame: 5 Hours
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Filtration fraction will be determined using be measured using infusion clearance technique of Chromium ethylenediaminetetraacetic acid (Cr-EDTA).
Measurements will be made in duplicates before and after administration of the study drug.
Glomerular filtration rate will be calculated as the filtration fraction multiplied by renal plasma flow.
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5 Hours
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Serum creatinine
Time Frame: 4 days
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Measurement of serum creatinine will be made daily the first 4 days after the study
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4 days
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Sven-Erik Ricksten, Professor, Sahlgrenska Academy, dept of clinical science
Publications and helpful links
General Publications
- Bragadottir G, Redfors B, Ricksten SE. Effects of levosimendan on glomerular filtration rate, renal blood flow, and renal oxygenation after cardiac surgery with cardiopulmonary bypass: a randomized placebo-controlled study. Crit Care Med. 2013 Oct;41(10):2328-35. doi: 10.1097/CCM.0b013e31828e946a.
- Tholen M, Ricksten SE, Lannemyr L. Effects of levosimendan on renal blood flow and glomerular filtration in patients with acute kidney injury after cardiac surgery: a double blind, randomized placebo-controlled study. Crit Care. 2021 Jun 12;25(1):207. doi: 10.1186/s13054-021-03628-z.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Kidney Diseases
- Urologic Diseases
- Wounds and Injuries
- Renal Insufficiency
- Acute Kidney Injury
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Vasodilator Agents
- Enzyme Inhibitors
- Protective Agents
- Cardiotonic Agents
- Phosphodiesterase Inhibitors
- Phosphodiesterase 3 Inhibitors
- Simendan
Other Study ID Numbers
Other Study ID Numbers
- SahlgrenskaUHThoraxLL3
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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