- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT07630220
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
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Detaljert beskrivelse
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
Registrering (Antatt)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
- Navn: Alexander Zarbock, MD
- Telefonnummer: +49-251-8347255
- E-post: zarbock@uni-muenster.de
Studer Kontakt Backup
- Navn: Nadja Schöne, MD
- Telefonnummer: +49-8347262
- E-post: nadja.schoene@ukmuenster.de
Studiesteder
-
-
-
Münster, Tyskland, 48149
- University Hospital Munster
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Beskrivelse
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
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Forebygging
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: Early filter change
Scheduled filter change during continuous renal replacement therapy at 36 ± 3 hours.
|
The time span of the filter change during continuous renal replacement therapy will be specified
|
|
Aktiv komparator: Standard of Care filter change
Standard of care with scheduled filter change during continuous renal replacement therapy at 72 hours.
|
The time span of the filter change during continuous renal replacement therapy will be specified
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Mean filter lifespan per patient
Tidsramme: From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
|
Comparison of mean filter lifespans between study groups
|
From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
|
|
Protocol adherence as documented filter change within the specified period
Tidsramme: 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
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
New intensive care unit (ICU)-associated acquired infection up to day 30
Tidsramme: From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
|
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
|
From start of CRRT to end of CRRT or at day 30 after randomization, whatever occurs first
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Studiestol: Alexander Zarbock, MD, University Hospital Muenster, Dept. of Anesthesiology, Intensive Care Medicine and Pain Therapy
Publikasjoner og nyttige lenker
Generelle publikasjoner
- 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.
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
- Urogenitale sykdommer
- Patologiske prosesser
- Mannlige urogenitale sykdommer
- Nyresykdommer
- Urologiske sykdommer
- Kvinnelige urogenitale sykdommer
- Kvinnelige urogenitale sykdommer og graviditetskomplikasjoner
- Sykdomsattributter
- Nyreinsuffisiens
- Patologiske tilstander, tegn og symptomer
- Kritisk sykdom
- Akutt nyreskade
- Infeksjoner
Andre studie-ID-numre
- AnIt26-02
- DRKS00039623 (Registeridentifikator: Deutsches Register Klinischer Studien (DRKS))
Plan for individuelle deltakerdata (IPD)
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