- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04321148
Protect Kidney Trial
November 4, 2022 updated by: Heinrich-Heine University, Duesseldorf
Prospective Randomized Study Comparing Impella Support Plus Optimal Medical Care Versus Optimal Medical Care Alone in Patients at High Risk for Contrast-induced Nephropathy Undergoing Elective Percutaneous Revascularization
This trial is a randomized, controlled, open-label, parallel study.
Patients at high risk for contrast induced acute kidney injury (CI AKI) and planned high-risk percutaneous coronary intervention (PCI) will be randomized to receive optimal medical care for the prevention of CI AKI with periprocedural hydration either in combination with or without use of an Impella device during PCI.
Renal function will be assessed over 6 months, potential complications (in particular bleeding and access site complications) over one month.
Effects of device-assisted PCI on pathways for salt and water handling, as well as on kidney oxygenation will be detected by sequential sampling of blood and urine as well as detection of magnetic resonance imaging indicative of blood kidney oxygenation (BOLD MRI).
Study Overview
Status
Recruiting
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
224
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Ralf Westenfeld, MD
- Phone Number: +2118118800
- Email: ctu@med.uni-duesseldorf.de
Study Contact Backup
- Name: Lisa Dannenberg
- Phone Number: +211807924
- Email: ctu@med.uni-duesseldorf.de
Study Locations
-
-
NRW
-
Dusseldorf, NRW, Germany, 40225
- Recruiting
- Heinrich-Heine-University, Div. of Cardiology, Pulmonary Disease and Vascular Medicine
-
Contact:
- Ralf Westenfeld, MD
- Phone Number: +49 211 81 18800
- Email: ralf.westenfeld@med.uni-duesseldorf.de
-
Contact:
- M.A.
-
Sub-Investigator:
- Patrick Horn, MD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 85 years (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Signed and dated informed consent obtained before any trial-related activities.
- Patients aged 18-85 years (both inclusive) with clinical indication for coronary angiogram with potential high-risk PCI
- Patients at high risk for contrast induced acute kidney injury as indicated by a preliminary Mehran Score ≥ 10 (contrast media volume is assumed to be < 100 ml)
Exclusion Criteria:
- Previous participation in this trial. Participation is defined as randomized.
- Patients with contraindications to use of an Impella heart pump (mural thrombus in the left ventricle; presence of a mechanical aortic valve or aortic valve stenosis (equivalent orifice area of 1.5 cm2 or less); moderate to severe aortic insufficiency (echocardiographic assessment graded as ≥ +2); in whom severe peripheral arterial disease precluding placement of an Impella system)
- Patients where hemodynamic support is deemed potentially required for PCI as assessed by at least one physician
- Patients needing emergency percutaneous coronary intervention (e.g. STEMI patients)
Patients with acute cardiogenic shock indicated by one of the following:
- Systolic blood pressure < 90mmHg over 30 minutes or inotropic support needed to maintain blood pressure targets.
- Killip class III & IV
- MCS already in place to maintain blood pressure and organ perfusion
- Patients with on-going resuscitation
- Unwitnessed cardiac arrest OR ≥30 minutes of CPR prior to screening OR any impairment in mental status, cognition, or any global or focal neurological deficit
- Patients on mechanical ventilation.
- Patients diagnosed with AKI within the last seven days prior to screening or incipient AKI. (In cases, where AKI cannot be ruled out as a cause for elevated serum creatine, a rise or fall above 30% of a second serum creatinine measurement obtained within 12 to 24 hours is indicative of AKI)
- Patients with an eGFR < 20 ml/min/1.73 m²
- Suspected or known pregnancy
- Patients with comorbidity that in the Investigator's opinion would limit life expectancy to less than 6 months
- Patients with other medical, social, or psychological problems that, in the opinion of the Investigator, preclude them from undergoing Impella-protected PCI or the study-related procedures, evaluations, and follow-up.
- Patients with severe anemia as indicated by hemoglobin concentrations < 8.5 g/dl at the time of screening.
- Patients who were exposed to contrast media in the last seven days prior to the time of screening
- Mental incapacity, unwillingness or language barriers precluding adequate understanding or cooperation.
- Participation in the active treatment or follow-up phase of another clinical study of an investigational drug or device which has not reached its primary end point.
Patients with contraindications against MRI-procedures (e.g. patients with pacemakers) are eligible for the study but will not participate in the BOLD-MRI assessment.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
OTHER: standard of care PCI
|
optimal medical care PCI
|
EXPERIMENTAL: Impella-protected PCI
|
Impella-protected PCI
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence rate of Contrast-induced acute kidney injury (CI-AKI)
Time Frame: 2 days after PCI
|
Incidence rate of AKI (Acute Kidney Injury Criteria 1-3) over 2 days after PCI
|
2 days after PCI
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in eGFR
Time Frame: at day 1 and day 3 from baseline (pre-PCI)
|
at day 1 and day 3 from baseline (pre-PCI)
|
|
Incidence of acute kidney injury (AKIN Criteria 1-3)
Time Frame: over 3 days after PCI
|
over 3 days after PCI
|
|
Incidence of dialysis
Time Frame: up to 6 months after PCI
|
Incidence of dialysis during hospitalization and over 6 months after PCI
|
up to 6 months after PCI
|
Incidence of re-hospitalization for renal dysfunction
Time Frame: 30 days and up to 6 months after PCI
|
Incidence of re-hospitalization for renal dysfunction over 30 days and 6 months after PCI
|
30 days and up to 6 months after PCI
|
Mortality
Time Frame: up to 6 months after PCI
|
Mortality during hospital stay and over 6 months after PCI
|
up to 6 months after PCI
|
Length of hospital stay
Time Frame: up to 3 days after PCI
|
up to 3 days after PCI
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
January 24, 2020
Primary Completion (ANTICIPATED)
December 1, 2023
Study Completion (ANTICIPATED)
December 1, 2023
Study Registration Dates
First Submitted
March 16, 2020
First Submitted That Met QC Criteria
March 24, 2020
First Posted (ACTUAL)
March 25, 2020
Study Record Updates
Last Update Posted (ACTUAL)
November 7, 2022
Last Update Submitted That Met QC Criteria
November 4, 2022
Last Verified
November 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 18-018 (Hammersmith Medicines Research Ltd)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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