Protocol to Assess the Severity of Acute Kidney Injury (AKI)
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Purpose
The principal objective is to safely determine if we can identify the severity of Acute Kidney Injury (AKI) early in the course of the disease. Once enrolled, we will draw blood and urine for relevant biomarkers. Our goal is to validate if any of these biomarkers can predict the course of AKI (recovery v. RRT v. death)
| Condition | Intervention |
|---|---|
|
Acute Kidney Failure |
Drug: Furosemide |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Prevention |
| Official Title: | Protocol to Assess the Severity of Acute Kidney Injury |
- Patients meeting the definition for stage 3 of Acute Kidney injury as defined by the Acute Kidney Injury Network (AKIN-3) system. [ Time Frame: 14 days or discharge (whichever occurs first) ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 150 |
| Study Start Date: | April 2008 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | August 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Drug: Furosemide
One dose: 1 mg/kg (iv)if the patient is furosemide naive or 1.5 mg/kg (iv) if patient is not furosemide naive.
Other Name: Lasix
|
Detailed Description:
AKI is a very common disease in the intensive care unit. However, despite advances in supportive care, patients with AKI carry a high mortality rate (50% to 70%). The established AKI affects nearly 5 percent of hospitalized persons and as many as 15 percent of critically ill patients. Currently, there are no FDA approved therapeutic agents for the treatment of AKI.
Retrospective studies suggest that the early initiation of renal replacement therapy (RRT) improves outcome. Many clinicians tend to take a "wait and see" approach because they do not want to dialyze a patient who is destined to recover renal function without the need for RRT. Therefore, it is vitally important to know early in the course which patients with AKI are likely to progress to RRT.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- 18 years and older
- Increase in serum creatinine of 0.3 mg/dl within 48 hours or an increase of greater or equal to 150 to 200% from baseline or sustained oliguria(mean urine output of <0.5 cc/kg/hr for 6 hours within 48 hours)
- Written informed consent
- Patients who already have a indwelling bladder catheter
Exclusion Criteria:
- Voluntary refusal or missing written consent of the patient or the designated legal representative
- Patients with advanced Chronic Kidney Disease - as defined by a baseline GFR of < 30 ml/min as calculated by the MDRD equation
- Patients with renal transplantation
- Pregnancy
- Patients with an allergy or sensitivity to loop diuretics
Patients with a clinical syndrome consistent with pre-renal AKI
- Defined by fractional excretion of Na of < 1% AND no evidence of the urinary casts, or
- Patients that are under-resuscitated as deemed by treating clinical team or
- Patients who are actively bleeding
Patients with a clinical syndrome of post-renal AKI
- Any radiological study that shows hydro-ureter, or
- Clinical scenario wherein the obstruction is considered a likely possibility of the cause of AKI
Contacts and Locations| Contact: Lakhmir S Chawla, MD | 202-715-4570 | lchawla@mfa.gwu.edu |
| United States, District of Columbia | |
| George Washington University Hospital | Recruiting |
| Washington, District of Columbia, United States, 20037 | |
| Contact: Lakhmir S Chawla, MD 202-715-4570 lchawla@mfa.gwu.edu | |
| Principal Investigator: Lakhmir S Chawla, MD | |
| Principal Investigator: | Lakmir S Chawla, MD | George Washigton University |
More Information
Publications:
| Responsible Party: | Lakhmir Chawla, Associate Professor of Medicine, George Washington University |
| ClinicalTrials.gov Identifier: | NCT00673244 History of Changes |
| Other Study ID Numbers: | IRB# 010835 |
| Study First Received: | April 15, 2008 |
| Last Updated: | February 8, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by George Washington University:
|
Renal Replacement Therapy Dialysis |
Additional relevant MeSH terms:
|
Acute Kidney Injury Renal Insufficiency Kidney Diseases Urologic Diseases Furosemide Sodium Potassium Chloride Symporter Inhibitors Membrane Transport Modulators |
Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Diuretics Natriuretic Agents Physiological Effects of Drugs Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 22, 2013