Indvirkning af tvungen diurese på restfragmenteringsfrekvensen efter fleksibel ureteroskopi til destruktion af nyresten med laser: et randomiseret kontrolleret to-parallel gruppe multicenterforsøg med blindningsevaluering (FIREStones)
BRANDSTENE: Indvirkning af tvungen diurese på den resterende fragmenteringshyppighed efter fleksibel ureteroskopi til destruktion af nyresten med laser: et randomiseret kontrolleret to-parallel gruppe multicenterforsøg med blindningsevaluering
In view of the positive results of the numerous studies conducted on forced diuresis after extra-corporeal lithotripsy, the investigators chose to evaluate forced diuresis by injection of Furosemide associated with intravenous hydration, which has never before been the subject of a specific analysis.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Flexible ureteroscopy is the most common technique to treat kidney stones and is the treatment of choice in France.
Kidney stones destruction requires its laser pulverization into small fragments in order to remove them through the ureter or improve their spontaneous expulsion along the urinary tract. However, most of the time, all the micro-fragments and dust created during stone destruction cannot be extracted using our surgical tools, and may stay intra-renally at the end of the procedure. Although these micro-fragments are expected to disappear spontaneously by the natural flushing and peristalsis of the upper urinary tract, they remain at risk of stagnation that could be the nest of new aggregation and stone formation.
Adjuvant treatments (such as forced diuresis, inversion or mechanical pressure) were previously described to improve the expulsion of stone fragments after extra-corporeal shock wave lithotripsy.
Nevertheless, the impact of adjuvant treatment after flexible ureteroscopy remains unclear and mainly theoretical.
In view of the positive results of the numerous studies conducted on forced diuresis after extra-corporeal lithotripsy, the investigators chose to evaluate forced diuresis by injection of Furosemide associated with intravenous hydration, which has never before been the subject of a specific analysis.
Loop diuretics (including Furosemide) significantly increase diuresis, which results in a greater flow of urine into the renal cavities, improving the chances of evacuating the residual fragments of the stone destroyed during flexible ureteroscopy, before they can sediment in the fundus of the renal calices or in the pyelon. Therefore, the investigators hypothesize that a forced diuresis with an injection of Furosemide at the end of ureteroscopy could improve the micro-fragments and stones dust clearance.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 3
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Marie-Lou LETOUCHE, MD
- Telefonnummer: +33247474665
- E-mail: marielou.letouche@gmail.com
Studiesteder
-
-
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Angers, Frankrig
- Rekruttering
- CHU d'Angers
-
Kontakt:
- Pierre BIGOT
- Telefonnummer: +332 41 35 64 94
- E-mail: pibigot@chu-angers.fr
-
Ledende efterforsker:
- Pierre BIGOT
-
Lyon, Frankrig
- Rekruttering
- Hospices Civils de Lyon
-
Kontakt:
- Nadia ABID
- Telefonnummer: +33472119675
- E-mail: nadia.abid@chu-lyon.fr
-
Ledende efterforsker:
- Nadia ABID
-
Nice, Frankrig
- Rekruttering
- CHU de Nice
-
Kontakt:
- Mathieu DURAND
- Telefonnummer: +33492031637
- E-mail: durand.m@chu-nice.fr
-
Ledende efterforsker:
- Mathieu DURAND
-
Nîmes, Frankrig
- Rekruttering
- CHU de Nîmes
-
Kontakt:
- Stéphane DROUPY
- Telefonnummer: +334 66 68 33 53
- E-mail: stephane.droupy@chu-nimes.fr
-
Ledende efterforsker:
- Stéphane DROUPY
-
Rennes, Frankrig
- Rekruttering
- CHU de Rennes
-
Kontakt:
- Karim BENSALAH
- Telefonnummer: +332 99 28 42 70
- E-mail: charles-karim.BENSALAH@chu-rennes.fr
-
Ledende efterforsker:
- Karim BENSALAH
-
Rouen, Frankrig
- Rekruttering
- CHU de Rouen
-
Kontakt:
- Hugo DUPUIS
- Telefonnummer: +332 32 88 89 90
- E-mail: hugo.dupuis@chu-rouen.fr
-
Ledende efterforsker:
- Hugo DUPUIS
-
Toulouse, Frankrig
- Rekruttering
- CHU de Toulouse
-
Ledende efterforsker:
- Xavier GAME
-
Kontakt:
- Xavier GAME
- Telefonnummer: +33561323106
- E-mail: game.x@chu-toulouse.fr
-
Toulouse, Frankrig
- Rekruttering
- Clinique La Croix du Sud
-
Kontakt:
- Christophe ALMERAS
- Telefonnummer: +335 32 02 72 02
- E-mail: c.almeras@gmail.com
-
Ledende efterforsker:
- Christophe ALMERAS
-
Tours, Frankrig
- Rekruttering
- CHRU de Tours
-
Kontakt:
- Marie-Lou LETOUCHE
- Telefonnummer: +336 74 75 71 13
- E-mail: marielou.letouche@gmail.com
-
Ledende efterforsker:
- Marie-Lou LETOUCHE
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Patients ≥ 18 years old and < 80 years old
- With the need to perform a flexible ureteroscopy with destruction of the kidney stones with laser
- Participants covered by or entitled to social security
- Written informed consent obtained from the participant
- Ability for participant to comply with the requirements of the study
Exclusion Criteria:
-
Persons covered by articles L1121-5 to L1121-8 of the CSP (corresponding to all protected persons: pregnant women, parturients, nursing mothers, persons deprived of their liberty by judicial or administrative decision, minors, and persons subject to a legal protection measure: guardianship or trusteeship)
-
Contra-indication to Furosemide:
- Hyper-sensitivity to the active substance or one of the excipients
- Hyper-sensitivity to Sulfonamide
- Renal failure with oligo-anuria refractory to Furosemide
- Hypokalemia < 3,5 mmol/L
- Severe hyponatremia
- Hypovolemia with or without hypotension or dehydration
- Ongoing hepatitis, hepatic insufficiency severe and hepatic encephalopathy
-
Patient having Furosemide as usual treatment
-
Patient requiring an injection of Aminoside or Vancomycin before or during the procedure
-
Participation in other interventional research with an investigational drug or medical device
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: Furosemide
Injection of 40 mg of Furosemide during 10 minutes after the end of the flexible ureteroscopy for destruction of kidney stones with laser. |
Injection of 40 mg of Furosemide during 10 minutes after the end of the flexible ureteroscopy for destruction of kidney stones with laser. |
|
Ingen indgriben: Usual care
Usual care, without injection of Furosemide. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Rate of stone free patients
Tidsramme: At 3 months
|
Rate of stone-free patients 3 months after a flexible ureteroscopy for renal stone laser destruction, evaluated on the low dose abdomino-pelvic CT-Scan. A centralized review of the images will be performed by two specialized radiologists, in a blind and crossed way to allow a homogenization of the results |
At 3 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Rate of urinary infection
Tidsramme: From baseline to 30 days
|
Rate of post-operative urinary tract infection will be assessed within 30 days after surgery on the combination of:
|
From baseline to 30 days
|
|
Pain in a scale
Tidsramme: During the hospital stay
|
Post-operative pain will be assessed on numerical pain scale in the recovery room, in the service and at the discharge. Pain scale is from 0 (no pain) to 10 (as bad as it could be nothing else matters) |
During the hospital stay
|
|
Opioid consumption
Tidsramme: During the hospital stay, an average of 1 day
|
The use of opioids will be reported |
During the hospital stay, an average of 1 day
|
|
Number of participants with adverse events
Tidsramme: From baseline to 3 months, an average of 1 day
|
Number of participants with Furosemide adverse events |
From baseline to 3 months, an average of 1 day
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Urogenitale sygdomme
- Mandlige urogenitale sygdomme
- Calculi
- Patologiske Tilstande, Anatomiske
- Nyresygdomme
- Urologiske sygdomme
- Urogenitale sygdomme hos kvinder
- Kvinders urogenitale sygdomme og graviditetskomplikationer
- Urolithiasis
- Urinvejsregning
- Nephrolithiasis
- Patologiske tilstande, tegn og symptomer
- Nyre Calculi
- Svovlforbindelser
- Organiske kemikalier
- Amider
- Anilinforbindelser
- Aminer
- Sulfonamider
- Sulfanilamider
- Sulfoner
- Furosemid
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2022-502890-40-00
- DR220258 (Anden identifikator: Promoter reference)
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
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