Ultra-Low Contrast Angiography in AKI
Randomized Controlled Trial of Ultra-Low Contrast Coronary Angiography During Acute Kidney Injury (AKI)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The study is a non-inferiority open-label randomized controlled trial. Hospitalized patients who have AKI at admission or who develop AKI during admission and require invasive coronary angiography will be included in the trial. Once indication for invasive coronary angiography is determined, patients will be randomized to immediate angiography or to delayed angiography after renal function stabilizes. Immediate angiography will be performed within 24 of enrollment. Serum creatinine will be collected on enrollment, within 6 hours before coronary angiography, and at 24h, 48h and 1-week after the angiography, as expected in common practice. Pre- and post-hydration administration will be at the discretion of the treating physician. In case percutaneous coronary intervention is indicated it will be schedule for 7 days after angiography.
Definitions: AKI is defined as an increase in serum creatinine by ≥50% from baseline within 7 days or an increase in serum creatinine by ≥0.3 mg/dl within 2 days. CIN is defined as an increase in serum creatinine by 0.5mg/dl or a relative rise of 25% from the baseline value.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Zach Rozenbaum, MD
- Phone Number: 504-988-5493
- Email: zrozenbaum@tulane.edu
Study Locations
-
-
Louisiana
-
New Orleans, Louisiana, United States, 70112
- Recruiting
- Tulane University Medical Center
-
Principal Investigator:
- Zach Rozenbaum, MD
-
Contact:
- Zach Rozenbaum, MD
- Phone Number: 504-988-5493
- Email: zrozenbaum@tulane.edu
-
New Orleans, Louisiana, United States, 70112
- Recruiting
- University Medical Center
-
Principal Investigator:
- Zach Rozenbaum, MD
-
Contact:
- Zach Rozenbaum, MD
- Phone Number: 504-988-5493
- Email: zrozenbaum@tulane.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Hospitalized patients who have AKI at admission or who develop AKI during admission and require invasive coronary angiography will be included in the trial.
Exclusion Criteria:
- Stabilized renal function manifested by unchanged or downtrending serum creatinine during a 24-hour period prior to enrollment.
- Contraindication for invasive coronary angiography other than AKI.
- Percutaneous coronary intervention is indicated and cannot be postponed by 7 days.
- Need for renal replacement therapy before coronary angiography or planned renal replacement therapy after coronary angiography (if premeditated before coronary angiography).
- Administration of intravascular contrast media during 7 days prior to the coronary angiography or within 6 days after coronary angiography.
- Pregnant patients, prisoners, cognitively impaired subjects, age below 18 years, unable or unwilling to provide informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Immediate intervention arm
Immediate angiography will be performed within 24 hours of enrollment.
Omnipaque contrast will be administered.
Serum creatinine will be collected on enrollment, within 6 hours before coronary angiography, and at 24h, 48h and 1-week after the angiography, as expected in common practice.
Pre- and post-hydration administration will be at the discretion of the treating physician.
In case percutaneous coronary intervention is indicated it will be schedule for 7 days after angiography.
|
Coronary angiography with less than 20cc of contrast materials
|
|
Placebo Comparator: Delayed intervention arm
Delayed angiography will be performed after kidney function stabilizes.
|
Coronary angiography with less than 20cc of contrast materials
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in incidence of Contrast Induced Nephropathy (CIN)
Time Frame: Within 7 days
|
CIN is defined as an increase in serum creatinine by 0.5mg/dl or a relative rise of 25% from the baseline value.
The investigators will measure the incidence of CIN by the increase in serum creatinine to see if the incidence will be the same in both arms whether the patient received the immediate angiography or if it was delayed until kidney function has been stabilized.
|
Within 7 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of earlier occurrence of CIN
Time Frame: Within 7 days
|
The investigators will measure serum creatinine at 24, 48 hours and at 1 week to measure if the occurrence of CIN will happen earlier in 1 arm than the other
|
Within 7 days
|
|
Incidence of renal replacement therapy at up to 7 days post-angiography
Time Frame: Within 7 days
|
The investigators will measure the incidence of renal replacement therapy by monitoring if the patient will undergo dialysis within 7 days post angiography
|
Within 7 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Zach Rozenbaum, MD, Tulane University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
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
Keywords
Additional Relevant MeSH Terms
- Urogenital Diseases
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Renal Insufficiency
- Acute Kidney Injury
- Investigative Techniques
- Diagnostic Techniques and Procedures
- Diagnosis
- Diagnostic Imaging
- Diagnostic Techniques, Cardiovascular
- Diagnostic Techniques, Neurological
- Radiography
- Angiography
- Neuroradiography
- Neuroimaging
- Cerebral Angiography
Other Study ID Numbers
Other Study ID Numbers
- 2023-874
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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