- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04522635
Fluid Mobilization in Hospitalized Patients With Acute Kidney Injury
August 20, 2020 updated by: Ravindra Mehta, University of California, San Diego
Hospitalized patients often suffer from an acute shutdown of kidney function secondary to infections, use of antibiotics, or use of intravenous contrast agents.
This results in the accumulation of toxic substances and retention of fluid in the body.
Dialysis techniques are often needed to manage these patients to remove the retained toxic substances and extra fluid and allow the kidney time to recover.
The amount and duration of fluid accumulation have been associated with a higher risk of death and longer hospital stays.
Correction of fluid overload with dialysis has been shown to be beneficial in improving the outcomes from these patients.
Most patients are quite sick and often have low levels of a blood protein called albumin that makes them more prone to developing low blood pressure during dialysis and limits the ability of dialysis to remove solutes and fluid adequately.
Often dialysis sessions are complicated by the development of low blood pressures and symptoms such as nausea, vomiting, and headaches that further compromises dialysis efficacy.
In this study, the hypothesis that addition of intravenous albumin during the dialysis session will improve the ability to remove fluid and reduce the incidence of low blood pressure during dialysis thereby improving patient tolerance and the efficacy of the procedure will be tested.
Patients with acute kidney failure or end-stage Renal Disease who need dialysis for fluid removal will be allocated to receive albumin or saline as intravenous fluids during individual dialysis sessions and information on how much fluid can be removed and how many complications occur in each session will be recorded.
Dialysis sessions with albumin will be compared with those with saline alone to determine the benefit of adding albumin to the treatment.
Information obtained from this study will allow physicians to manage patients requiring dialysis for acute kidney failure more effectively and help improve outcomes.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This study will address the following questions:
AIM 1: Can the utilization of intravenous albumin enhance the efficacy of fluid removal in hospitalized patients undergoing dialysis for AKI or ESRD.
The hypothesis to be tested:
- Addition of albumin solutions to dialysis therapy will enhance the efficacy of fluid removal (total amount of fluid removed)
- Albumin solutions will improve the efficiency of fluid removal by dialysis per unit time
- Albumin addition will reduce the time to achieving and maintaining fluid balance and correcting fluid overload.
AIM 2: Can the utilization of IV albumin improve the safety of fluid removal during dialysis?
The hypothesis to be tested:
- Addition of albumin solutions will reduce the frequency of Intradialytic hypotension associated with fluid removal on dialysis.
- Albumin solutions given during dialysis will reduce the incidence and magnitude of myocardial stunning associated with fluid removal on dialysis
- Albumin solutions given during dialysis will reduce post-dialysis symptoms AIM 3: Does utilization of IV albumin improve the microcirculation in hospitalized patients undergoing fluid removal with dialysis?
The hypothesis to be tested:
- Patients with AKI or ESRD will have deranged microcirculatory profile as compared to normal
- During fluid removal with dialysis changes in microcirculation correlate with alterations in hemodynamics related to the rate and amount of fluid removal
- Utilization of IV albumin during dialysis will reduce the microcirculatory stress of fluid removal
Study Type
Interventional
Enrollment (Actual)
65
Phase
- Phase 4
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
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- age > 18 years old
- need for intermittent hemodialysis during hospitalization
- hypoalbuminemia (albumin<3g/dl)
Exclusion Criteria:
- allergy to the components of albumin
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: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: albumin
albumin (100 ml of Grifols 25%) given intravenously at the start of IHD
|
single dose of 25g albumin (100 ml of Grifols 25%) given intravenously at the start of IHD
Other Names:
|
PLACEBO_COMPARATOR: normal saline
0.9% sodium chloride (normal saline (NS)) given intravenously at the start of IHD
|
single dose of 25g albumin (100 ml of Grifols 25%) given intravenously at the start of IHD
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
fluid removal
Time Frame: during procedure
|
achieved fluid removal expressed as ml/kg/hour
|
during procedure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
hypotension
Time Frame: during procedure
|
cardiovascular complications, including hypotensive episodes
|
during procedure
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Ravindra L Mehta, MD, UCSD
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the 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)
June 3, 2015
Primary Completion (ACTUAL)
December 15, 2017
Study Completion (ACTUAL)
December 31, 2019
Study Registration Dates
First Submitted
August 18, 2020
First Submitted That Met QC Criteria
August 18, 2020
First Posted (ACTUAL)
August 21, 2020
Study Record Updates
Last Update Posted (ACTUAL)
August 24, 2020
Last Update Submitted That Met QC Criteria
August 20, 2020
Last Verified
August 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 141779
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
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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