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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)

4. november 2026 opdateret af: University Hospital, Tours

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

Rekruttering

Betingelser

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

Interventionel

Tilmelding (Anslået)

374

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

      • Angers, Frankrig
        • Rekruttering
        • CHU d'Angers
        • Kontakt:
        • Ledende efterforsker:
          • Pierre BIGOT
      • Lyon, Frankrig
        • Rekruttering
        • Hospices Civils de Lyon
        • Kontakt:
        • Ledende efterforsker:
          • Nadia ABID
      • Nice, Frankrig
        • Rekruttering
        • CHU de Nice
        • Kontakt:
        • Ledende efterforsker:
          • Mathieu DURAND
      • Nîmes, Frankrig
        • Rekruttering
        • CHU de Nîmes
        • Kontakt:
        • Ledende efterforsker:
          • Stéphane DROUPY
      • Rennes, Frankrig
      • Rouen, Frankrig
        • Rekruttering
        • CHU de Rouen
        • Kontakt:
        • Ledende efterforsker:
          • Hugo DUPUIS
      • Toulouse, Frankrig
        • Rekruttering
        • CHU de Toulouse
        • Ledende efterforsker:
          • Xavier GAME
        • Kontakt:
      • Toulouse, Frankrig
        • Rekruttering
        • Clinique La Croix du Sud
        • Kontakt:
        • Ledende efterforsker:
          • Christophe ALMERAS
      • Tours, Frankrig
        • Rekruttering
        • CHRU de Tours
        • Kontakt:
        • Ledende efterforsker:
          • Marie-Lou LETOUCHE

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 80 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

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

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / 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

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

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:

  • Fever higher than 38.5°C and/or,
  • Chills and/or,
  • Clinical symptoms (supra-pubic pain, dysuria, pollakiuria, urgency, urinary burning, back pain radiating to the genitals, hematuria) and/or
  • Positive urine culture with a significant bacteriuria threshold defined as bacteriuria ≥10^5 UFC/mL with one or two bacterial species.
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

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

4. januar 2024

Primær færdiggørelse (Anslået)

1. april 2028

Studieafslutning (Anslået)

1. april 2028

Datoer for studieregistrering

Først indsendt

14. juni 2023

Først indsendt, der opfyldte QC-kriterier

14. juni 2023

Først opslået (Faktiske)

23. juni 2023

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

9. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

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)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Ingen

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Ingen

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