Low-intensity Versus Medium-intensity Continuous Kidney Replacement Therapy for Critically Ill Patients

NCT ID: NCT06014801

Last Updated: 2024-10-15

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

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-30

Study Completion Date

2026-09-30

Brief Summary

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This clinical trial aims to investigate whether the low treatment intensity (12 mL/kg/hr, low-dose hemodialysis/filtration) or the medium treatment intensity (25 mL/kg/hr, standard-dose hemodialysis/filtration) is more effective and safer for continuous renal replacement therapy in critically ill patients.

Detailed Description

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Conditions

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Acute Kidney Injury Requiring Continuous Renal Replacement Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Low intensity

12 mL/kg/hr

Group Type EXPERIMENTAL

Dialysate fluid, Filtration replacement fluid

Intervention Type DRUG

Dose of continuous hemodialysis and/or hemofiltration

Medium intensity

25 mL/kg/hr

Group Type ACTIVE_COMPARATOR

Dialysate fluid, Filtration replacement fluid

Intervention Type DRUG

Dose of continuous hemodialysis and/or hemofiltration

Interventions

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Dialysate fluid, Filtration replacement fluid

Dose of continuous hemodialysis and/or hemofiltration

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Adults (18 years of age or older, regardless of the time since ICU admission) currently admitted to an intensive care unit\*.

\*Includes high care units, where continuous monitoring is conducted and intensive care physicians are in charge of medical care.
2. A diagnosis of acute kidney injury is made according to the Kidney Disease: Improving Global Outcomes (KDIGO) international diagnostic criteria (one of the following is met)

* Serum creatinine increased by more than 0.3 mg/dL within 48 hours
* Serum creatinine increased more than 1.5-fold from baseline and the increase is considered to have occurred within 7 days
* Oliguria (\< 0.5 mL/kg/hr) lasting more than 6 hours
3. The treating intensivist believes that continuous kidney replacement therapy is necessary

Exclusion Criteria

1. Receiving chronic dialysis or scheduled for initiation of chronic dialysis
2. Undergoing any kidney replacement therapy or blood purification therapy within 48 hours
3. When kidney replacement therapy using other dialysate or replacement fluids, such as citrate dialysis, is preferred due to coexisting bleeding disorders or allergy to acetate
4. Concomitant blood purification therapy other than hemofiltration/dialysis, such as plasma exchange
5. The patient is in a very critical condition and the treating physician believes that survival for more than 24 hours is unlikely
6. Previous participation in the study
7. After receiving a full explanation of the study and with full understanding, a patient do not consent to participate in the study of their own (or their substitute decision maker's) will.
8. The principal investigator (or an investigator) thinks it to be inappropriate to participate in this study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Fukui

OTHER

Sponsor Role collaborator

Tsuchiura Kyodo General Hospital

OTHER

Sponsor Role collaborator

Keio University

OTHER

Sponsor Role collaborator

Wakayama Medical University

OTHER

Sponsor Role collaborator

Jichi Medical University

OTHER

Sponsor Role collaborator

Sendai Medical Center

UNKNOWN

Sponsor Role collaborator

Osaka Medical and Pharmaceutical University Hospital

UNKNOWN

Sponsor Role collaborator

Jikei University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Tomoko Fujii

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Tomoko Fujii, MD,PhD

Role: STUDY_CHAIR

Jikei University School of Medicine

Locations

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Sendai Medical Center

Sendai, Miyagi, Japan

Site Status NOT_YET_RECRUITING

Osaka Medical and Pharmaceutical University Hospital

Takatsuki, Osaka, Japan

Site Status NOT_YET_RECRUITING

University of Fukui Hospital

Fukui, , Japan

Site Status NOT_YET_RECRUITING

Tsuchiura Kyodo General Hospital

Ibaraki, , Japan

Site Status RECRUITING

Osaka University Hospital

Osaka, , Japan

Site Status NOT_YET_RECRUITING

Jichi Medical University Hospital

Tochigi, , Japan

Site Status NOT_YET_RECRUITING

Jikei University Hospital

Tokyo, , Japan

Site Status RECRUITING

Keio University Hospital

Tokyo, , Japan

Site Status RECRUITING

Wakayama Medical University Hospital

Wakayama, , Japan

Site Status NOT_YET_RECRUITING

Countries

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Japan

Central Contacts

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Tomoko Fujii, MD,PhD

Role: CONTACT

+81 3 3433 1111

Facility Contacts

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Yu Kawazoe, MD, PhD

Role: primary

+81 22 293 1111

Yu Amemiya, MD

Role: primary

+81 72 683 1221

Aiko Tanaka, MD, PhD

Role: primary

+81 776 61 3111

Akira Endo, MD, PhD

Role: primary

+81 29 830 3711

Naoya Iguchi, MD, PhD

Role: primary

+81 6 6879 5111

Hisashi Imahase, MD

Role: primary

Tomoko Fujii, MD, PhD

Role: primary

+81 3 3433 1111 ext. 4070

Ryo Yamamoto, MD, PhD

Role: primary

+81 3 3353 1211

Kyohei Miyamoto, MD, PhD

Role: primary

+81 73 447 2300

References

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Beaubien-Souligny W, Thompson Bastin M, Teixeira JP, Cerda J, Connor MJ Jr, Dijanic Zeidman A, Garimella PS, Juncos L, Lopez-Ruiz A, Mehta R, Reis T, Rizo-Topete L, Silver SA, Da Silva JR, Speer R, Vijayan A, Wells C, Wille K, Yessayan L, Tolwani A, Neyra JA. Proceedings of the University of Alabama at Birmingham Continuous Renal Replacement Therapy Academy (2023-2024): Managing De-Escalation of Acute Renal Replacement Therapy and Optimizing Drug Dosing during Renal Replacement Therapy Transitions. Kidney360. 2025 Oct 1;6(10):1798-1809. doi: 10.34067/KID.0000000951. Epub 2025 Aug 8.

Reference Type DERIVED
PMID: 40779331 (View on PubMed)

Other Identifiers

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jRCTs031230292

Identifier Type: REGISTRY

Identifier Source: secondary_id

JKI23-002

Identifier Type: -

Identifier Source: org_study_id

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