Effect of Intravenous Iron Repletion on Renal Function in Patients With Iron Deficiency and Acute Kidney Injury

NCT ID: NCT05960227

Last Updated: 2024-10-01

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

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-06

Study Completion Date

2024-09-30

Brief Summary

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This clinical trial aims to carry out research on the effect on hemoglobin and renal function of intravenous administration of iron dextran as a repletion strategy in patients with iron deficiency anemia and acute kidney injury, in which the patient may benefit from this drug as it is expected to correct anemia, ferropenia and renal function parameters, when compared with a control group (placebo), the safety of the drug will also be assessed by recording adverse effects.

The investigators will point out with the patient the risks and benefits of their inclusion in this type of study and the investigators will attend to all the doubts that are generated, as well as immediately report to the research ethics committee any serious adverse effects. The results will be presented at national and international conferences and will be published in high-impact journals, and will also be the subject of a thesis to achieve the title of specialist.

Detailed Description

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Acute kidney injury is a complication that occurs in up to 30% of hospitalized patients, iron deficiency has a high incidence in the critically ill patient population and has been associated with multiple complications such as the development of anemia and renal dysfunction. The presence of iron deficiency, anemia and acute kidney damage is a common combination in critically ill patients and it has been seen that iron deficiency promotes mitochondrial dysfunction and this can be improved with the correction of intravenous iron, as has happened in clinical trials of patients with acute heart failure, improving their clinical evolution.

There is insufficient evidence for the implementation of intravenous iron with the aim of improving the parameters of iron deficiency anaemia in patients with acute kidney injury.

To the knowledge of the investigators, there is no clinical trial that has explored this outcomes.

Primary objective:

• Renal function estimated in GFR at 3 months after randomization. Which will be evaluated by the estimation of the GFR by the equation CKD-EPI by serum creatinine

Secondary objectives: all of the following will be at hospital discharge and 28 days after hospital discharge between the intervention group (iron replacement) compared to the control group (placebo).

* ferritin value, (pg/dL)
* transferrin saturation (%)
* Hemoglobin (g/dL)
* serum creatinine (mg/dL)
* initiation of renal support therapy (any type of renal support such as: intermittent haemodialysis, peritoneal dialysis or continuous therapies)
* recovery of renal function, seen as decreased serum creatinine and approaching \<0.3mg/dL of baseline creatinine
* death

Exploratory objectives:

• safety of intravenous iron administration compared to placebo: assessed for the occurrence of adverse events such as allergic reaction, hypotension, dyspnea, rash, erythema. These will be evaluated during the administration of the drug and during hospitalization frequently every 24 hours by the nephrology staff that includes the study researchers.

Our hypothesis is that intravenous iron dextran repletion during the treatment of acute kidney injury will improve the parameters of renal function, iron deficiency, anemia and also that it will be safe compared to placebo.

STUDY DESIGN Randomized, placebo-controlled clinical trial, method of randomization in blocks of 5 by frequency of occurrence. In patients with acute renal injury, they will be aleatorized to receive the administration of intravenous iron dextran in 1 single exhibition according to the Mg granted by the Virizzi formula compared to placebo.

The sample size determined 55 patients per group, with a standard deviation of 1.5.

The randomization process was carried out with the NCI Clinical Trial Randomization Tool:

https://ctrandomization.cancer.gov/

Conditions

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Anemia, Iron Deficiency Acute Kidney Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized, placebo-controlled clinical trial, method of randomization in blocks of 5 by frequency of occurrence. In patients with acute renal injury, patients will be allearorized to receive intravenous iron dextran in 1 single exhibition according to the Mg granted by the Virizzi formula compared to placebo.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Iron dextran IV

In patients with acute renal damage, they will be aleatorized to receive the administration of intravenous iron dextran 1200mg in 1 single exhibition compared to placebo.

Group Type EXPERIMENTAL

Iron dextran

Intervention Type DRUG

Administration of 1.2g of iron dextran in infusion bolus as a loading strategy.

Placebo

In patients with acute renal damage, they will be aleatorized to receive the administration of placebo.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

250ml of saline 0,9% for 4 hours insusion.

Interventions

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Iron dextran

Administration of 1.2g of iron dextran in infusion bolus as a loading strategy.

Intervention Type DRUG

Placebo

250ml of saline 0,9% for 4 hours insusion.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Hospitalized patients with acute kidney injury
* iron levels \<13 μmol/L or a transferrin saturation \<20%

Exclusion Criteria

* AKI within the past three months
* less than 18 years old
* Chronic Kidney Disease grade 5
* chronic dialysis
* kidney transplant
* hospital stay less tahn 48 hours
* received any red blood cell transfusion before randomization
* missing data that would render analysis incomplete.
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Civil de Guadalajara

OTHER

Sponsor Role lead

Responsible Party

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Jonathan Samuel Chavez Iñiguez

Head of nephrology Jonathan Samuel Chavez Iñiguez MD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hospital Civil de Guadalajara

Guadalajara, Jalisco, Mexico

Site Status

Jonathan Samuel Chávez Iñiguez

Guadalajara, Jalisco, Mexico

Site Status

Countries

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Mexico

References

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Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, Liu KD, Mehta RL, Pannu N, Van Biesen W, Vanholder R. Acute kidney injury: an increasing global concern. Lancet. 2013 Jul 13;382(9887):170-9. doi: 10.1016/S0140-6736(13)60647-9. Epub 2013 May 31.

Reference Type BACKGROUND
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Siew ED, Davenport A. The growth of acute kidney injury: a rising tide or just closer attention to detail? Kidney Int. 2015 Jan;87(1):46-61. doi: 10.1038/ki.2014.293. Epub 2014 Sep 17.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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HCG

Identifier Type: -

Identifier Source: org_study_id

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