Acute Kidney Injury After Cardiac Surgery

NCT ID: NCT03396770

Last Updated: 2021-12-02

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

848 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-14

Study Completion Date

2021-09-16

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Acute kidney injury (AKI) is common after cardiac surgery. The diagnosis is based on the criteria defined by the Kidney Disease Improving Global Outcomes (KDIGO) classification: oliguria and elevation of serum creatinine. However, oliguria is not specific of AKI and elevation of serum creatinine is too late. Therefore, new methods have been developed to earlier assess the risk of AKI.

Among those methods, it has been shown that the increase of urinary dosage, in the hours following the surgery, of two proteins (Tissue Inhibitor of Metallo-Protease 2 (TIMP2) and Insulin Growth Factor Binding Protein 7 (IGFBP7)) is associated with an increased risk of occurrence of AKI in patients hospitalized in intensive care unit. The Nephrocheck® test combines the urinary dosage of those two proteins TIMP2 and IGFBP7.

Insofar as post-surgery low cardiac output is one curable cause of AKI, the early detection of early kidney risk allows corrective measures to stabilize hemodynamic state and thus to reduce the risk of AKI.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The usual diagnostic markers of AKI are defaulted. Indeed, oliguria tends to overstate the impact of AKI, up to 40-50% of patients. Postoperative increased serum creatinine is a late marker for the AKI. Furthermore, perioperative hemodilution and serum creatinine kinetic delay the postoperative peak of serum creatinine from 48 to 72 h.

Nephrocheck® test combines the urinary dosage of 2 proteins (TIMP2 and IGFBP7). These 2 proteins are excreted by the tubular cell in case of suffering whatever the origin, for example tissue hypoxia by low renal blood flow or a systemic inflammatory response. In a medical ICU, the test performed within 4 to 12 hours after kidney aggression can predict the onset of persistent AKI beyond 4 weeks.

Until randomization, all patients are treated according to the standard of care for the center. This includes a blood test upon arrival in the intensive care unit and continuous monitoring of vital parameters.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Acute Kidney Injury Cardiac Surgery

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Urinary biomarkers Intensive Care Unit

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

open labeled randomized clinical trial
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Control group

Standard clinical routine

Group Type ACTIVE_COMPARATOR

Standard clinical routine

Intervention Type PROCEDURE

Patient management is carried out according to the usual service protocol

Nephrocheck group

Nephrocheck test

Group Type EXPERIMENTAL

Nephrocheck test

Intervention Type PROCEDURE

Nephrocheck® test is realized 4 hours after the end of the cardiopulmonary bypass

* If the test is positive, hemodynamic evaluation is carried out and adapted therapy to result of this evaluation is initiated.
* If the test is negative, patient management is carried out according to the usual protocol.
* A second test is realized 6 hours after the first test whatever the result of it.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Standard clinical routine

Patient management is carried out according to the usual service protocol

Intervention Type PROCEDURE

Nephrocheck test

Nephrocheck® test is realized 4 hours after the end of the cardiopulmonary bypass

* If the test is positive, hemodynamic evaluation is carried out and adapted therapy to result of this evaluation is initiated.
* If the test is negative, patient management is carried out according to the usual protocol.
* A second test is realized 6 hours after the first test whatever the result of it.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* On-pump cardiac surgery ;
* Informed and written consent of the patient or inclusion according to the emergency procedure;
* Affiliated patient or beneficiary of a social protection

Exclusion Criteria

* Left and / or right ventricular assist device;
* Heart transplant;
* Chronic kidney disease with renal replacement therapy before surgery;
* Hemorrhagic shock requiring surgical hemostasis at the time of randomization
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

JRAR Association

UNKNOWN

Sponsor Role collaborator

Rennes University Hospital

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Sébastien BIEDERMANN, MD

Role: PRINCIPAL_INVESTIGATOR

CHU Rennes

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Rennes University Hospital

Rennes, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2017-A01935-48

Identifier Type: OTHER

Identifier Source: secondary_id

35RC17_8822

Identifier Type: -

Identifier Source: org_study_id