Acute Kidney Injury After Cardiac Surgery

NCT ID: NCT04293744

Last Updated: 2023-12-06

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

TERMINATED

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-04

Study Completion Date

2023-10-31

Brief Summary

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PrimECC is a colloid priming solution for cardiopulmonary bypass/ extracorporeal circulation (ECC) based on Ringers Lactate, supplmeneted with Dextran 40 and Dextran 1. In a previous RCT comparing PrimECC with crystalloid priming fluid, patients in the PrimECC group experienced less hemolysis, less tubular cell injury and beneficial effect on the fluid balance. This study will investigate if, in a population at high risk of acute kidney injury (AKI), priming the ECC circuit with PrimECC instead of crystalloid solution will lead to a reduction of postoperative AKI. The hypothesis is that PrimECC, compared to crystalloid prime, will reduce postoperative AKI.

The study is a Swedish multicenter, double-blinded, randomized, controlled clinical trial. The trial will include 366 patients aged ≥18 years, scheduled for cardiac surgery with cardiopulmonary bypass, with an "Acute kidney injury risk score" ≥30% according to Birnie et al. (2014). The primary outcome of the study is the incidence of postoperative AKI of any stage according to the KDIGO creatinine criteria (serum-creatinine increase ≥ 27 μmol/l within 48 h or ≥ 50 % increase from baseline) within 96 hours after arrival to the ICU. Secondary outcomes are between-group differences in hemolysis, tubular cell injury (NAG-excretion), estimated GFR, and incidence of AKI of different stages according to the KDIGO creatinine criteria. In addition, differences in CNS (Tau, NFL, NSE, and S100B) and cardiac (TNT/TNI) injury markers will be investigated.

Detailed Description

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Conditions

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Cardiac Surgical Procedures Extracorporeal Circulation; Complications Acute Kidney Injury

Keywords

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Colloid priming solution Cardiopulmonary bypass Extracorporeal circulation ECC Acute Kidney Injury AKI

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Colloid priming solution for ECC circuit

Priming of ECC circuit with approximately 1200 mL PrimECC.

Group Type EXPERIMENTAL

Colloid priming solution for ECC circuit

Intervention Type DEVICE

Prospective, multi-center, double-blinded, randomized, controlled clinical trial

Standard priming solution for ECC circuit

Priming of ECC circuit with approximately 1200 mL standard priming solution (crystalloid solution with or without mannitol addition as per routine of the participating clinic).

Group Type ACTIVE_COMPARATOR

Standard priming solution for ECC circuit

Intervention Type DEVICE

Prospective, multi-center, double-blinded, randomized, controlled clinical trial

Interventions

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Colloid priming solution for ECC circuit

Prospective, multi-center, double-blinded, randomized, controlled clinical trial

Intervention Type DEVICE

Standard priming solution for ECC circuit

Prospective, multi-center, double-blinded, randomized, controlled clinical trial

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Has signed and dated the EC approved informed consent
* Subject is ≥ 18 years of age
* Requires elective or urgent (non-emergency) cardiac procedure requiring the use of ECC.
* Preoperative "Acute kidney injury risk score" ≥30%, found at http://cardiacsurgeryleicester.com/our-research/acute-kidney-injury-risk-score-calculator/

Exclusion Criteria

* Unable to give informed consent
* Known bleeding disorder
* Known intolerance or contraindication to dextran
* Acute Surgery (requires emergency cardiac procedure/surgery)
* Currently using an antithrombotic medication which has not been discontinued per institution protocol
* Malignancy; Surgery within 5 years or ongoing antitumoral treatment
* Has ongoing sepsis or endocarditis
* Requires pre-operative dialysis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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XVIVO Perfusion

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lukas Lannemyr, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Sahlgrenska University Hospital

Locations

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Sahlgrenska University Hospital

Gothenburg, Västra Götaland County, Sweden

Site Status

Countries

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Sweden

References

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Juvakka O, Wallinder A, Moller-Sorensen PH, Matschke K, Jeppsson A, Lannemyr L. Dextran vs. Crystalloid Priming Solution in Cardiac Surgery: A Randomized Trial on Acute Kidney Injury. Acta Anaesthesiol Scand. 2026 Jan;70(1):e70139. doi: 10.1111/aas.70139.

Reference Type DERIVED
PMID: 41144782 (View on PubMed)

Other Identifiers

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Priming II Trial

Identifier Type: -

Identifier Source: org_study_id