- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02276066
Kidney Response to Sepsis Affects Angiogenic Balance and Likelihood of CCI and PICS
Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS): A New Horizon for Surgical Critical Care Subtitle. Kidney Response to Sepsis Affects Angiogenic Balance and Likelihood of CCI and PICS
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The main goal of this project is to measure kidney filtration function at day 14 or the day of discharge from hospital (whichever occurs first), in order to determine the presence and magnitude of persistent kidney dysfunction after sepsis episode and to longitudinally assess further decline of kidney function at one year follow-up. The measure of the glomerular filtration rate (GRF) in patients with chronic critical illness and controls (sepsis patients discharged from ICU before day 14) will be used to determine to what degree of kidney dysfunction contributes to decreased survival and increase in chronic kidney disease at year one after sepsis onset.
One and/or all of the three ways for GFR assessment will be used, both at approximately day 14 or approximately at the day of discharge from the ICU and at the one year follow up :
- Determine clearance of Iohexol from blood after Iohexol injection and/or
- Determine apperance of Iohexol in urine after Iohexol injection (this would be the same injection as in one, and would not require two injections) and/or
- A timed urine collection to determine clearance of urea and creatinine and/or
- Estimated GFR using calculations with serum creatinine and cystatin C,
This will provide an opportunity to validate the different measurements.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Florida
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Gainesville, Florida, United States, 32610
- UF Health at Shands hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Presence in the surgery or trauma ICU
- Age of ≥18 years
- Entrance into our sepsis protocol
- Ability to obtain informed consent.
Exclusion Criteria:
- Expected lifespan of the patient is less than 3 months due to severe pre-existing comorbidities (ex. recurrent, advanced or metastatic cancer)
- Severe traumatic brain injury (evidence of neurologic injury on CT scan and a GCS <8)
- Refractory shock (i.e., patients who die within 12 hours)
- Uncontrollable source of sepsis (e.g., irreversible disease state such as unresectable dead bowel)
- Patient or patient's family are not committed to aggressive management of the patient's condition and/or the patient has a DNR/DNI on file.
- Severe CHF (NY Heart Association Class IV)
- Child-Pugh C liver disease or pre-liver transplant.
- Known HIV infection with CD4 count <200 cells/mm3
- Organ transplant recipient on immunosuppressive agents
- Known pregnancy and mother's that are breastfeeding
- Prisoners
- Institutionalized patients
- Inability to obtain informed consent.
- Chemotherapy or radiotherapy within 30 days prior to sepsis.
- End stage renal disease on admission.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Inhospital group at day 14
This group of sepsis participants will remain hospitalized after day 14.
A normal saline dilution of Iohexol 0.5-1 ml will be given IV push.
Blood or urine will be collected prior to the injection and at approximately 1, 2, 3, and 4 hours after the injection for glomerular filtration rate measurements.
This test will be repeated in one year.
In addition to or as an option would be to have a timed urine collection to determine clearance of urea and creatinine can be performed instead of the saline dilution of Iohexol 0.5-1 ml and/or an estimated of GFR using serum creatinine and cystatin C measurement using calculations from blood samples.
|
Both groups of sepsis participants will receive a normal saline dilution of Iohexol 0.5-1 ml given by IV push.
Blood or urine will be collected prior to the injection and at approximately 1, 2, 3, and 4 hours after the injection for glomerular filtration rate measurements.
This test will be repeated in one year.
Other Names:
Both groups of sepsis participants will have urine collected for at least 4 hours to as long as 24 hours or more.
The urine volume determined and a sample sent to the lab for determination of creatinine and urea concentration.
Both groups of sepsis participants will provide peripheral blood samples to the research staff.
The samples will be sent to the laboratory for serum creatinine and cystatin C results.
|
Other: Released from hosptial prior to day 14
This group of sepsis participants will be released from the hospital prior to day 14.
A normal saline dilution of Iohexol 0.5-1 ml will be given IV push.
Blood or urine will be collected prior to the injection and at approximately 1, 2, 3, and 4 hours after the injection for glomerular filtration rate measurements.
This test will be repeated in one year.
In addition to or as an option would be to have a timed urine collection to determine clearance of urea and creatinine can be performed instead of the saline dilution of Iohexol 0.5-1 ml and/or an estimated of GFR using serum creatinine and cystatin C measurement using calculations from blood samples.
|
Both groups of sepsis participants will receive a normal saline dilution of Iohexol 0.5-1 ml given by IV push.
Blood or urine will be collected prior to the injection and at approximately 1, 2, 3, and 4 hours after the injection for glomerular filtration rate measurements.
This test will be repeated in one year.
Other Names:
Both groups of sepsis participants will have urine collected for at least 4 hours to as long as 24 hours or more.
The urine volume determined and a sample sent to the lab for determination of creatinine and urea concentration.
Both groups of sepsis participants will provide peripheral blood samples to the research staff.
The samples will be sent to the laboratory for serum creatinine and cystatin C results.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Area under the curve versus time curve (AUC) of Iohexol
Time Frame: 0, 1, 2, 3, and 4 hours post-dose
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The decline in iohexol glomerular filtration rate at day 14 and 1 year follow-up between chronic crucial illness and control groups.
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0, 1, 2, 3, and 4 hours post-dose
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Serum Creatinine
Time Frame: Day 14
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The correlation between iohexol glomerular filtration rate and estimated glomerular filtration rate using previously validated equation applied to serum creatinine in both groups.
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Day 14
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Serum Creatinine
Time Frame: 1 year
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The correlation between iohexol glomerular filtration rate and estimated glomerular filtration rate using previously validated equation applied to serum creatinine in both groups.
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1 year
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Urine Urea Concentration
Time Frame: Day 14
|
The urine will be collected for at least 4 hours to as long as 24 hours or more.
The urine volume determined and a sample sent to the lab for determination of urea concentration.
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Day 14
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Urine Urea Concentration
Time Frame: 1 year
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The urine will be collected for at least 4 hours to as long as 24 hours or more.
The urine volume determined and a sample sent to the lab for determination of urea concentration.
|
1 year
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Urine Creatinine Ratio
Time Frame: Day 14
|
The urine will be collected for at least 4 hours to as long as 24 hours or more.
The urine volume determined and a sample sent to the lab for determination of creatinine.
|
Day 14
|
Urine Creatinine Ratio
Time Frame: 1 year
|
The urine will be collected for at least 4 hours to as long as 24 hours or more.
The urine volume determined and a sample sent to the lab for determination of creatinine.
|
1 year
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Mark Segal, M.D., University of Florida
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB201400795-N
- P50GM111152-01 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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