- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03329313
Effects of Variation of Sodium Dialysate in ICU (NADIRA)
Effects of Variation of Sodium Dialysate in ICU Acute Kiney Injury
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Acute kidney injury (AKI) requiring renal replacement therapy (RRT) occurs in 5 to 6% of critically ill patients and is associated with high mortality and significant health resource utilization. Modalities of RRT currently available include intermittent hemodialysis/diafiltration (IHD/F) and continuous renal replacement therapies. Continuous veno-venous therapies have gained wide application in ICUs, often supplanting IHD because of the belief that it is better tolerated in hemodynamically unstable patients. Previous reports have shown however that intermittent therapies may permit similar hemodynamic tolerance but with specific parameters including dialysate composition. Consequently, international guidelines suggest in ICU AKI the use of intermittent modalities with the use of cold dialysate, increased duration session, decreased blood and dialysate flows, and high level of sodium dialysate concentration (≥ 145mmol/l). Increasing the level of sodium dialysate concentration improves obviously the hemodynamic tolerance but may also result in inflated extracellular volume and fluid overload secondary to sodium transfert from the dialysate compartment to the blood. There is a body of evidence that fluid overload may be harmful to the critically ill, has an adverse impact and worsens outcome.
The aim of the study is therefore to compare perdialytic hemodynamic tolerance and fluid overload after 7 days of SLEDD-f using 2 sodium dialysate concentrations -140 vs 145 mmol/l- in ICU AKI patients. The investigators also planned to evaluate and compare mean ultrafiltration rate by patient, total duration of RRT, fluid overload at RRT weaning, ICU length of stay and 28 days ICU mortality using these 2 levels of sodium dialysate concentration.
Methods: This randomised, single center, prospective and non blinded study is being held in medical ICU at Lapeyronie University Hospital of Montpellier.
Patient more than 18 years old, admitted to the ICU for AKI requiring RRT and with a sSofa score > 5 will be included.
RRT will be an on line predilution SLEDD- with the following parameters: blood flow 200ml/min, dialysate flow 200ml/min, infusate flow 60ml/min, temperature 36°C, membrane polysulfone Fx80. An hemodynamic monitoring will be performed at each dialysis session. Weight, daily input and output and extracellular volume will be monitored during ICU stay.
According to the sodium concentration dialysate: 140 or 145 mmol/l, 2 groups will be randomized and compared regarding to hemodynamic tolerance, fluid overload and outcome.
Hypothesis: The use of a sodium dialysate concentration at 140 mmol/l with SLEDD-f will induce a similar intradialytic hemodynamic tolerance as compared to a Na dialysate at 145 mmmol/l but with a decrease at around 4% of fluid overload.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: vincent BRUNOT, MD
- Phone Number: 33 467332495
- Email: v-brunot@chu-montpellier.fr
Study Contact Backup
- Name: kada KLOUCHE, MD, PhD
- Phone Number: 33 467338441
- Email: k-klouche@chu-montpellier.fr
Study Locations
-
-
-
Montpellier, France, 34295
- Recruiting
- UHMontpellier
-
Contact:
- vincent BRUNOT, MD
- Phone Number: 33 467332495
- Email: v-brunot@chu-montpellier.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion criteria:
- Age > 18 years old
- Acute kidney injury requiring renal replacement therapy
- Dialysis type: on line sustained low efficiency dialy dialysis -filtration
- SOFA score > 5
- Sodium serum level between 135 and 145mmol/l
Exclusion criteria:
- Chronic kidney disease stade IV ou V
- Obstrutive acute kidney injury
- Renal tansplantation in the year before ICU admission
- Moribund with risk of death in the 48 hours
- Vulnerable persons or protected persons
- Pregnant or breastfeeding mother
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Low sodium concentration
Concentration of sodium in dialysate at 140 mmol/l ( Lowering sodium concentration dialysate)
|
Concentration of sodium in dialysate at 140 mmol/l
Other Names:
|
Sham Comparator: High Sodium Concentration
Concentration of sodium in dialysate at 145 mmol/l (Highing sodium concentration dialysate)
|
Concentration of sodium in dialysate at 145 mmol/l
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Fluid overload
Time Frame: 7 days after the initiation of renal replacement therapy
|
Daily weight measure from the initiation to the weaning of RRT.
Daily monitoring of inpout and output.
|
7 days after the initiation of renal replacement therapy
|
Fluid overload
Time Frame: day 28
|
Daily weight measure from the initiation to the weaning of RRT.
|
day 28
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Intradialytic hemodynamic tolerance
Time Frame: during the requiring renal replacement therapy (RRT)
|
Intradialytic hemodynamic tolerance
|
during the requiring renal replacement therapy (RRT)
|
Mean ultrafiltration rate by patient/ session
Time Frame: 1 day
|
Appreciation of ultrafiltration rate for each patient and for each RRT session for all the renal replacement therapy.
Calcultate the mean ultrafiltration rate by patient.
Daily Weight measurement before and after each RRT session and daily
|
1 day
|
Fluid overload
Time Frame: 1 day
|
Fluid overload after RRT weaning and ICU stay.
|
1 day
|
Total duration of RRT
Time Frame: 1 day
|
Total duration of RRT at end of hospitalization
|
1 day
|
length of stay
Time Frame: 1 day
|
Length of stay in the service at hospital discharge
|
1 day
|
Mortality rate
Time Frame: 28 days of admission
|
Mortality rate at 28 days of admission
|
28 days of admission
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: vincent BRUNOT, MD, University Hospital, Montpellier
- Study Director: aurèle BUZANCAIS, MD, UHNIMES
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- UF9744
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
Clinical Trials on Acute Kidney Injury
-
Instituto Nacional de Cardiologia Ignacio ChavezInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranUnknownKidney Injury, Acute | Acute Renal Injury | Acute Kidney Injuries | Kidney Injuries, Acute | Acute Renal InjuriesMexico
-
Yonsei UniversityCompletedAcute Kidney Injury(Postoperative Acute Kidney Injury in Patients Undergoing Aortic Surgery)Korea, Republic of
-
University Hospital, GhentWithdrawn
-
Beni-Suef UniversityCairo UniversityRecruitingAKI - Acute Kidney InjuryEgypt
-
University Hospital MuensterBaxter Healthcare CorporationCompletedAcute Kidney Injury (AKI)Spain, France, United States, Turkey, Germany, Egypt, Italy, Libyan Arab Jamahiriya, Malta, North Macedonia, Palestinian Territory, occupied, Russian Federation, Saudi Arabia, Slovenia
-
Chinese PLA General HospitalBeijing Tsinghua Changgeng HospitalCompletedPostoperative Acute Kidney InjuryChina
-
Chinese PLA General HospitalCompletedPostoperative Acute Kidney InjuryChina
-
Ain Shams UniversityRecruiting
-
Chinese PLA General HospitalRecruitingPostoperative Acute Kidney InjuryChina
-
Nikola Bradic, MDUnknownAcute Kidney Injury (Nontraumatic)
Clinical Trials on Lowering sodium concentration dialysate
-
Aristotle University Of ThessalonikiCompletedEnd Stage Kidney Disease | Intradialytic HypertensionGreece, Slovenia
-
University of SydneyPeking University People's Hospital; Institute for Clinical Evaluative Sciences and other collaboratorsRecruitingEnd-Stage Kidney DiseaseAustralia, Canada, United Kingdom, Malaysia, Germany, India
-
VA Office of Research and DevelopmentActive, not recruitingEnd-stage Renal DiseaseUnited States
-
Tufts Medical CenterInBody; Dialysis Clinic, Inc.CompletedHypertension | Hemodialysis Complication | Fluid Overload | Dialysis Disequilibrium | Intra-dialytic HypotensionUnited States
-
University of AarhusCompletedEnd Stage Renal Disease on DialysisDenmark
-
Lawson Health Research InstituteCompleted
-
Brigham and Women's HospitalRecruitingIntradialytic Hypotension | Peri-dialytic Cardiac Rhythms | Electrolyte Changes | pH Changes | Adverse SymptomsUnited States
-
UPECLIN HC FM Botucatu UnespCompletedChronic Kidney Diseases Stage 5
-
Renal Research InstituteCompleted
-
University of MichiganRenal Research InstituteCompletedChronic Kidney Disease | ArrhythmiaUnited States