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The Effect of Standard vs. Shorter Filter Lifespan During Continuous Renal Replacement Therapy (SPECIAL)
The Effect of Standard vs. Shorter Filter Lifespan During Continuous Renal Replacement Therapy in Critically Ill Patients With Acute Kidney Injury - a Feasibility Randomized Controlled Trial
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Own data of patients under standard care indicated that a longer filter lifetime in CRRT is associated with an increased rate of new infections.
The aim of this study is to demonstrate that a protocolized filter-change strategy can be reliably implemented in critically ill patients and a high protocol adherence can be achieved.
The secondary aim is to investigate whether a shorter filter-change strategy is be associated with a lower incidence of newly acquired infections.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Alexander Zarbock, MD
- Telefoonnummer: +49-251-8347255
- E-mail: zarbock@uni-muenster.de
Studie Contact Back-up
- Naam: Nadja Schöne, MD
- Telefoonnummer: +49-8347262
- E-mail: nadja.schoene@ukmuenster.de
Studie Locaties
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-
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Münster, Duitsland, 48149
- University Hospital Munster
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-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Adult ≥ 18 years
- Critically ill patients with severe AKI consistent with KDIGO stage 3 and an absolute indication for CRRT
- Written consent form from the patient or legal representative or authorized representative or emergency inclusion
Exclusion Criteria:
- End-stage kidney disease or chronic dialysis dependence
- Chronic kidney disease with eGFR<20ml/min/1.73 m²
- Prior kidney transplant
- Prior renal replacement therapy during the index admission before randomization
- Glomerulonephritis, interstitial nephritis, vasculitis
- Patients on immunosuppression (above the cushing threshold)
- Patients with chronic inflammatory diseases (e.g. arthritis, HIV with a CD4 count of < 0.05 x 10E/l)
- Do-not resuscitate order
- Persons with any kind of dependency on the investigator or employed by the sponsor
- Patients participating in an interventional study involving measures to influence the immune system
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Early filter change
Scheduled filter change during continuous renal replacement therapy at 36 ± 3 hours.
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The time span of the filter change during continuous renal replacement therapy will be specified
|
|
Actieve vergelijker: Standard of Care filter change
Standard of care with scheduled filter change during continuous renal replacement therapy at 72 hours.
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The time span of the filter change during continuous renal replacement therapy will be specified
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Mean filter lifespan per patient
Tijdsspanne: From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
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Comparison of mean filter lifespans between study groups
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From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
|
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Protocol adherence as documented filter change within the specified period
Tijdsspanne: From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
|
Proportion of protocol adherent patients, defined as patients with mean filter lifespan within the pre-specified time window in each arm (intervention group: 36±3hours; control group: 48-72hours
|
From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
New intensive care unit (ICU)-associated acquired infection up to day 30
Tijdsspanne: From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
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Rate of new ICU-acquired infections, defined as new infection in patients with pre-existing infection but with another pathogen than baseline or without baseline infection.
All infections need to be culture proven.
Only the first infection per patient will be considered
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From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Studie stoel: Alexander Zarbock, MD, University Hospital Muenster, Dept. of Anesthesiology, Intensive Care Medicine and Pain Therapy
Publicaties en nuttige links
Algemene publicaties
- Zarbock A, Kullmar M, Kindgen-Milles D, Wempe C, Gerss J, Brandenburger T, Dimski T, Tyczynski B, Jahn M, Mulling N, Mehrlander M, Rosenberger P, Marx G, Simon TP, Jaschinski U, Deetjen P, Putensen C, Schewe JC, Kluge S, Jarczak D, Slowinski T, Bodenstein M, Meybohm P, Wirtz S, Moerer O, Kortgen A, Simon P, Bagshaw SM, Kellum JA, Meersch M; RICH Investigators and the Sepnet Trial Group. Effect of Regional Citrate Anticoagulation vs Systemic Heparin Anticoagulation During Continuous Kidney Replacement Therapy on Dialysis Filter Life Span and Mortality Among Critically Ill Patients With Acute Kidney Injury: A Randomized Clinical Trial. JAMA. 2020 Oct 27;324(16):1629-1639. doi: 10.1001/jama.2020.18618.
- Gerss J, Meersch M, Kindgen-Milles D, Brandenburger T, Willam C, Kellum JA, Zarbock A. The Effect of Filter Lifespan during Continuous Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury on the Rate of New-Onset Infection: Analysis from the RICH Randomized Controlled Trial. Am J Respir Crit Care Med. 2022 Aug 15;206(4):511-514. doi: 10.1164/rccm.202201-0063LE. No abstract available.
Studie record data
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Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
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Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Pathologische processen
- Mannelijke urogenitale ziekten
- Nier Ziekten
- Urologische ziekten
- Vrouwelijke urogenitale ziekten
- Vrouwelijke urogenitale ziekten en zwangerschapscomplicaties
- Ziekte attributen
- Nierinsufficiëntie
- Pathologische aandoeningen, tekenen en symptomen
- Kritieke ziekte
- Acuut nierletsel
- Infecties
Andere studie-ID-nummers
- AnIt26-02
- DRKS00039623 (Register-ID: Deutsches Register Klinischer Studien (DRKS))
Plan Individuele Deelnemersgegevens (IPD)
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Informatie over medicijnen en apparaten, studiedocumenten
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