Status:

RECRUITING

Initial Resuscitation for Acute Kidney Injury in Cirrhosis

Lead Sponsor:

Massachusetts General Hospital

Collaborating Sponsors:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Conditions:

Cirrhosis, Liver

Acute Kidney Injury

Eligibility:

All Genders

18+ years

Phase:

NA

Brief Summary

The goal of this interventional study is to evaluate two strategies for how to provide intravenous (IV) fluids for treating patients with acute kidney injury (AKI) in cirrhosis. The main question it a...

Detailed Description

This randomized, open-label, pilot feasibility trial will assess a volume assessment guidance algorithm (VAGA) in patients with AKI and cirrhosis. Eligible patients must have AKI and decompensated cir...

Eligibility Criteria

Inclusion

  • Adult age 18 years or greater
  • Signed informed consent form (ICF) by any subject capable of giving consent, or, when the subject is not capable of giving consent, by their legally authorized representatives prior to initiation of any study procedures.
  • Admitted to the hospital
  • Diagnosis of decompensated cirrhosis (either prior to admission or new diagnosis on admission).
  • Presence of acute kidney injury (AKI) as defined by International Club of Ascites (ICA) criteria, defined as SCr increase of ≥0.3 mg/dL within 48 hours or ≥50% increase from baseline which is known or presumed to have occurred within the prior 7 days.

Exclusion

  • Requiring \>2 liters (L) supplemental oxygen at the time of screening.
  • In shock requiring vasopressors (vasoconstrictors for the treatment of AKI such as terlipressin, midodrine, and octreotide are allowed).
  • Allergy or other contraindication to IV albumin administration.
  • Death, liver transplant, or renal replacement therapy (RRT) expected within 48 hours.
  • Patient and/or legally authorized representative unable to provide informed consent.
  • Hepatic encephalopathy grade 3 or 4 at the time of screening.
  • Already received \>200 g albumin during admission at the time of screening.
  • Severe, active bleeding requiring 3 or more units of red blood cell transfusion in the 48 hours prior to screening.
  • Admission to the intensive care unit at the time of screening.
  • Mechanical ventilation at the time of screening.
  • Presence of New York Heart Association (NYHA) class 3-4 symptoms of congestive heart failure at the time of screening.
  • History of prior liver or kidney transplant.
  • Pregnant or nursing status
  • Any condition, in the opinion of the investigator, that could confound or interfere with the safe completion of study activities.

Key Trial Info

Start Date :

September 12 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

September 1 2026

Estimated Enrollment :

50 Patients enrolled

Trial Details

Trial ID

NCT06525623

Start Date

September 12 2024

End Date

September 1 2026

Last Update

December 22 2025

Active Locations (1)

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1

Massachusetts General Hospital

Boston, Massachusetts, United States, 02114