Assessment of Kidney Function for Drug Dosage Adjustments in Critically Ill Patients

NCT ID: NCT03045692

Last Updated: 2017-02-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

172 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-13

Study Completion Date

2019-04-30

Brief Summary

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The aim of the study is to determine if colistin dosage adjustment using 4hr CrCl contribute to better clinical outcomes compared with drug dosage adjustment using eGFR in critical ill patients. In control group, colistin maintenance dosage will be decided using serum creatinine based eGFR (in ml/min). In study group, colistin maintenance dosage will be decided using 4hr CrCl.

Detailed Description

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1. Screening periods (From 'informed consents' to 'randomization')

* Check of inclusion/exclusion criteria ② Measurement of 4hr CrCl \& eGFR in ml/min

* calculation of maintenance dose ③ Baseline characteristics \& laboratory findings ④ Randomization
2. Colistin dosage Loading dose : 5 x body weight (not exceeding 300mg) Maintenance dose (after 12 hours from loading dose)

: 2.5 x (\[1.5 x GFR\] + 30) (divided doses every 12hours), GFR in ml/min

During the study period, daily morning serm creatinine levels are measured. Whenever serum creatinine concentration changes by more than 10% compared with baseline, 4hr CrCl will be mearued. At the every time of 4hr CrCl measurements, colistin dose wil be modified according to new GFR values (4hr CrCl in study group, eGFR in control group)
3. Blood sampling for Colistin trough level measurement Peripheral blood will be sampled twice between 72 hrs and 144 hours after loading dose, just before colistin infusion. The samples were collected in heparined tubes and centrifuged at 4 °C within 1 hr of collection. The resulting plasma was stored at - 70°C . And two values will be averaged out.
4. End of randomization (7 days after colistin initiation) ① Nephrotoxicity ② Treatment outcome microbiological outcome: eradication / no eradication clinical outcome: complete response / partial response / treatment failure

Conditions

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ICU Patients

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Double blind randomized trial
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Control group

creatinine based eGFR (which is not revised value with standardized body surface area, that is, 1.73m2) are used to decide colistin maintenance dosage.

Group Type ACTIVE_COMPARATOR

kidney function assessment by creatinine based eGFR

Intervention Type DIAGNOSTIC_TEST

creatinine based eGFR (which is not revised value with standardized body surface area, that is, 1.73m2) are used to decide colistin maintenance dosage.

Study group

4 hour creatinine clearance is used to decide colistin maintenance dosage.

Group Type EXPERIMENTAL

kidney function assessment by 4 hour creatinine clearance

Intervention Type DIAGNOSTIC_TEST

4 hour creatinine clearance is used to decide colistin maintenance dosage.

Interventions

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kidney function assessment by 4 hour creatinine clearance

4 hour creatinine clearance is used to decide colistin maintenance dosage.

Intervention Type DIAGNOSTIC_TEST

kidney function assessment by creatinine based eGFR

creatinine based eGFR (which is not revised value with standardized body surface area, that is, 1.73m2) are used to decide colistin maintenance dosage.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Patients aged over 18
2. Patients in intensive care unit received colistin for the microbiologically documented cases associated with carbapenem-resistant gram negative bacilli.

Exclusion Criteria

1. Patients who received colistin empirically.
2. Patients who received renal replacement therapy due to acute kidney injury or end-stage renal disease
3. Patients whose urine output was less than 0.5cc/kg/hr for 6 hrs
4. Patients who underwent hematopoietic stem cell transplantation
5. Patients who disagree with this study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Samsung Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Jung Eun Lee

Associate professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Jung Eun Lee, MD,PhD

Role: CONTACT

82-2-3410-6549

Other Identifiers

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2016-12-147-003

Identifier Type: -

Identifier Source: org_study_id

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