Cette page a été traduite automatiquement et l'exactitude de la traduction n'est pas garantie. Veuillez vous référer au version anglaise pour un texte source.

Venous Return Pressure Gradient as a Predictor of Acute Kidney Injury (VRPG-AKI)

22 juillet 2026 mis à jour par: Rongan Liu, Sichuan Academy of Medical Sciences

Venous Return Pressure Gradient Predicts Acute Kidney Injury Onset and Progression

Acute kidney injury (AKI) is a common and serious complication in the ICU. Current diagnostic indicators (such as creatinine and urine output) exhibit significant lag, and specific hemodynamic predictive markers are lacking. The venous return pressure gradient (Pmsf-CVP), based on Guyton's theory, reflects the driving pressure for venous return; however, its value in the early warning of AKI remains unclear. This study aims to investigate the predictive value of the venous return pressure gradient for the onset and progression of AKI in ICU patients, and to clarify its effectiveness as an AKI risk warning indicator.

Patients admitted to the ICU within 48 hours with risk factors for AKI (including sepsis, shock, major surgery, underlying diseases, etc.) who have radial artery catheterization and can undergo hemodynamic monitoring will be enrolled. Those undergoing maintenance dialysis/CRRT, ECMO support, or with missing core data precluding calculation of Pmsf-CVP or AKI assessment will be excluded.

The venous return pressure gradient (Pmsf-CVP, mmHg) will be measured within 48 hours of ICU admission using the transient stop-flow arm arterial-venous equilibrium pressure method. The primary outcome is to evaluate the association between the venous return pressure gradient level and AKI occurrence. Secondary outcomes include correlation analyses between the venous return pressure gradient level and serum creatinine and urine output within 48 hours of ICU admission, among others.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

AKI - Insuffisance rénale aiguë

Intervention / Traitement

Autre: No study intervention

Type d'étude

Observationnel

Inscription (Estimé)

180

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Nom: rongan Liu
Numéro de téléphone: +8615928731511
E-mail: 35279240@qq.com

Sauvegarde des contacts de l'étude

Nom: chunling Chen
Numéro de téléphone: +8618349304972
E-mail: cclblingk@163.com

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

Adulte
Adulte plus âgé

Accepte les volontaires sains

Non

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Adult ICU patients (age ≥18 years) at risk for acute kidney injury, with central venous and radial arterial catheters in place for hemodynamic monitoring, no AKI at ICU admission per KDIGO criteria, and complete data available for calculation of venous return pressure gradient (Pmsf-CVP) within 48 hours of admission.

La description

Inclusion Criteria:

Age ≥18 years
Admitted to the intensive care unit (ICU) within 48 hours
Central venous catheter in place for continuous central venous pressure (CVP) monitoring
Radial artery catheter in place for hemodynamic monitoring including mean systemic filling pressure (Pmsf)
No acute kidney injury (AKI) at ICU admission according to KDIGO criteria

Exclusion Criteria:

Maintenance hemodialysis or continuous renal replacement therapy (CRRT) prior to ICU admission
Previous kidney transplantation
Pregnancy
Extracorporeal membrane oxygenation (ECMO) support at ICU admission
Incomplete core hemodynamic data precluding calculation of venous return pressure gradient (Pmsf-CVP) or AKI assessment

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats	Description de la mesure	Délai
Acute Kidney Injury occurrence Délai: Within 48 hours of ICU admission	Occurrence of acute kidney injury diagnosed according to KDIGO criteria (serum creatinine increase ≥1.5 times baseline, or ≥26 μmol/L within 48 hours, or urine output <0.5 mL/kg/h for ≥6 hours) during the ICU stay. The association between venous return pressure gradient (Pmsf-CVP, measured within the first 48 hours of ICU admission using the Pmsf-arm method) and AKI occurrence will be assessed by multivariable logistic regression analysis, adjusting for APACHE II score, baseline serum creatinine, lactate, mean arterial pressure, sepsis, and shock.	Within 48 hours of ICU admission

Mesures de résultats secondaires

Mesure des résultats	Description de la mesure	Délai
Persistent Acute Kidney Injury Délai: Within 48 hours after AKI occurrence during the ICU stay	Persistent AKI defined as failure of renal function to return to baseline within 48 hours after AKI occurrence during the ICU stay. The predictive value of venous return pressure gradient (Pmsf-CVP) for persistent AKI will be evaluated by ROC curve analysis.	Within 48 hours after AKI occurrence during the ICU stay
AKI severity grade Délai: At the time of maximum AKI stage during the ICU stay, up to 28 days	Maximum AKI stage (KDIGO stage 1, 2, or 3) achieved during the ICU stay.	At the time of maximum AKI stage during the ICU stay, up to 28 days
In-hospital mortality Délai: From ICU admission to hospital discharge, up to 90 days	All-cause mortality during the index hospitalization.	From ICU admission to hospital discharge, up to 90 days
Total length of hospital stay Délai: From hospital admission to discharge or death, up to 90 days	Number of days from hospital admission to hospital discharge or in-hospital death, whichever comes first. Patients still hospitalized at day 90 will be censored at 90 days.	From hospital admission to discharge or death, up to 90 days
Correlation between venous return pressure gradient and serum creatinine Délai: Within 48 hours of ICU admission	Spearman rank correlation analysis between Pmsf-CVP (measured within 48 hours of ICU admission) and serum creatinine levels (baseline creatinine at ICU admission and peak creatinine during ICU stay).	Within 48 hours of ICU admission
Correlation between venous return pressure gradient and lactate Délai: Within 48 hours of ICU admission	Spearman rank correlation analysis between Pmsf-CVP (measured within 48 hours of ICU admission) and lactate levels obtained from the first arterial blood gas analysis within 48 hours of ICU admission.	Within 48 hours of ICU admission
Duration of mechanical ventilation Délai: From intubation to first successful extubation	Number of days on invasive mechanical ventilation from the time of first intubation to the first successful extubation. Reintubation within 48 hours will be counted as continuous ventilation.	From intubation to first successful extubation
Length of ICU stay Délai: From ICU admission to ICU discharge	Number of days from ICU admission to ICU discharge.	From ICU admission to ICU discharge

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Sichuan Academy of Medical Sciences

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

5 juillet 2026

Achèvement primaire (Estimé)

1 mai 2027

Achèvement de l'étude (Estimé)

1 mai 2027

Dates d'inscription aux études

Première soumission

30 juin 2026

Première soumission répondant aux critères de contrôle qualité

22 juillet 2026

Première publication (Réel)

23 juillet 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)