Kidney Injury

This research evaluates how well furosemide alone compares to furosemide combined with albumin in critically ill adults who have fluid overload. The study aims to find out if adding albumin improves urine output and kidney function markers compared to using furosemide by itself. Key measurements include urine output two hours after treatment, kidney blood flow indicators, and various biochemical tests. Participants are randomly assigned to receive either furosemide at 1 mg per kg of body weight intravenously over 30 minutes with a placebo, or the same dose of furosemide together with 50 grams of 25% albumin infused over 30 minutes. The study uses bedside ultrasound to assess fluid overload signs and monitors blood pressure, electrolytes, and kidney filtration rates during the trial. During the study, participants undergo urine output measurement at two hours and blood tests to track changes in kidney function and electrolyte levels up to 24 hours after treatment. Ultrasound evaluations assess vein size and congestion at baseline and after two hours. Researchers monitor safety and response to treatment while collecting data on urine volume and kidney health markers to understand the impact of adding albumin to furosemide therapy.

Researchers are studying how the drug MK-2828 behaves in the body over time, focusing on people with different levels of kidney disease compared to healthy individuals. This Phase 1 trial aims to understand the drugs pharmacokinetics, or how it is absorbed, distributed, metabolized, and eliminated in people with severe renal impairment, end-stage renal disease ESRD on hemodialysis, and healthy controls. Participants are divided into three groups based on kidney function. Those with severe renal impairment receive a single oral dose of MK-2828 on Day 1. Participants with ESRD on hemodialysis receive a single dose on Day 1 during two separate periods, with at least a 14-day break between doses. Healthy participants with normal kidney function also receive a single dose on Day 1. This open-label study does not involve randomization or blinding. During the trial, participants undergo blood sampling before dosing and at several time points up to 192 hours after receiving MK-2828 to measure drug concentrations and pharmacokinetic parameters. For those on hemodialysis, additional measurements related to dialysis clearance are collected up to 6 days. Safety is monitored by tracking adverse events for about two weeks. Participation lasts a few days depending on the dosing schedule and required sampling times.

Researchers are evaluating the use of Near Infrared Spectroscopy NIRS to predict acute kidney injury AKI in adult patients undergoing cardiac surgery with cardiopulmonary bypass. AKI is a common and serious complication after such surgeries, leading to increased hospital stays, costs, and mortality. This study aims to compare the effectiveness of NIRS sensors placed on the skin over the kidney versus sensors placed on the limbs for predicting AKI. The research is conducted by the University of Utahs anesthesiology department. Participants will have NIRS sensors placed on the skin over their kidney, as located by ultrasound, and on the muscles of their arm and thigh before surgery. If a patient has had a right nephrectomy, the sensor will be placed over the left kidney. Additional sensors will be placed on the forehead to measure brain oxygen levels during surgery. The study observes how well these sensor placements predict AKI from the day of surgery up to seven days afterward. During the study, participants will undergo ultrasound measurements to determine the depth of kidney and muscle tissue before sensor placement. Researchers will monitor oxygen levels in various tissues throughout surgery and track outcomes such as AKI development, ventilator times, length of hospital stay, and in-hospital mortality up to three months. Hemodynamic data including blood pressure, oxygen delivery, vasopressor use, and anemia during surgery will also be recorded. The total observation period extends from surgery through hospital discharge and follow-up for up to three months.

Researchers are evaluating whether using an automated Carbon Dioxide CO2 injection system during infrainguinal peripheral vascular interventions PVI can reduce major adverse kidney events within 90 days in patients at moderately increased risk for contrast-associated acute kidney injury CA-AKI. This Phase 3 randomized controlled trial compares a CO2-based contrast medium sparing strategy to the standard use of iodinated contrast media in patients with peripheral vascular and kidney diseases. Participants are randomly assigned to one of two groups. The intervention group receives PVI using an automated CO2 injection system as the primary contrast agent, with iodinated contrast media available as a backup if image quality is insufficient or if the patient cannot tolerate CO2 angiography. The control group undergoes routine PVI using iodinated contrast media according to local standards, avoiding high-osmolar contrast agents. All patients are followed for up to 12 months after their procedure. During the study, participants undergo the planned PVI procedure with either contrast method. Researchers carefully record the amount and reasons for any iodinated contrast media used in the CO2 group. Patients are monitored for kidney-related outcomes, focusing on major adverse kidney events up to 90 days after the intervention. The trial includes ongoing follow-up assessments to evaluate safety and effectiveness over one year.

Researchers are comparing two drugs, cilastatin and thiosulfate, to see which better protects the kidneys in female patients undergoing debulking surgery combined with intraoperative hyperthermic intraperitoneal chemotherapy HIPEC using cisplatin. This phase 2, double-blind, randomized clinical trial evaluates whether cilastatin is not less effective than thiosulfate in preventing kidney damage in this setting. Participants receive either 1.5 grams of cilastatin or thiosulfate during their debulking surgery with HIPEC. The study uses a triple-blind design to prevent bias and randomly assigns patients to one of the two treatment groups. The main focus is on kidney protection during and after this specialized chemotherapy procedure, which targets tumors in the abdomen. During the study, researchers monitor patients for kidney failure within the first seven days after surgery to measure the primary outcome. Patients are assessed for overall health and eligibility before surgery, and kidney function is carefully tracked. The total participant age range is 18 to 75 years, and only females diagnosed with ovarian cancer suitable for this surgery are included. The study runs until October 2028 with ongoing monitoring and evaluation.

Researchers are evaluating the use of a high protein egg white pudding as a nutritional supplement for people with kidney failure who are on dialysis. The study aims to find out if giving this egg white pudding after dialysis is practical and whether it can improve blood protein levels, frailty, dietary intake, and other blood markers compared to a standard supplement called Ensure Plus. This trial is conducted by Seven Oaks Hospital Chronic Disease Innovation Centre. Participants will be randomly assigned to receive either the egg white protein pudding or Ensure Plus at the end of their dialysis treatments three times a week for 12 weeks. Both supplements are dietary and taken during the dialysis sessions. The study collects data during this 12-week intervention period to evaluate the effects of the two supplements. During the study, participants will be monitored for their ability to stay in the trial, adherence to the supplements, and health measures such as hand grip strength, walking speed, balance, and blood levels including serum albumin and electrolytes. These assessments occur at the end of the 12 weeks. The trial also tracks recruitment and follow-up rates to evaluate feasibility. Overall, participants are involved in regular supplement intake and health testing during dialysis over three months.

Researchers are developing and validating a machine learning model to predict acute kidney injury AKI after non-cardiac surgery in adult patients. The study also aims to assess whether including frailty status as a new factor improves the models ability to predict AKI. This observational study uses data collected from patients undergoing various types of non-cardiac surgeries. The study uses two sets of data retrospective data from adult patients who had non-cardiac surgery between July 2015 and June 2025, and prospective data collected from July 2025 to February 2026. The retrospective data helped develop and optimize the model using multiple machine learning techniques and a wide range of patient and surgical information. The prospective data includes frailty assessments and will be used to validate and update the model. Participants information such as demographics, lab tests, comorbidities, and surgical details are collected from electronic medical records. For the prospective group, frailty status and outcomes like postoperative complications, mortality, hospital stay length, and costs are recorded. The primary outcome measured is acute kidney injury within 7 days after surgery. The study tracks these outcomes during the perioperative period to evaluate the models performance and value of frailty assessment.

Researchers are evaluating a predictive tool called the Multifactorial Dynamic Perfusion Index MDPI to estimate the risk of acute kidney injury after cardiac surgery involving cardiopulmonary bypass CPB. This observational study involves adults and infants undergoing cardiac surgery, aiming to validate the MDPI in adults, develop a version for infants under 20 kg, and explore if the MDPI can predict other complications including mortality. The MDPI combines seven variables measured during CPB, many of which can be modified by the surgical team to potentially improve patient outcomes. The study is divided into three parts first, validating the MDPI in 800 adult cardiac surgery patients from two centers using existing CPB monitors that collect data such as hematocrit, oxygen delivery, arterial pressure, and transfusions second, developing a modified MDPI for 200 infants under 20 kg undergoing congenital heart surgery with additional infant-specific variables and third, investigating whether the MDPI can predict other postoperative issues like low cardiac output, longer ICU stays, bleeding complications, and 30-day mortality. Data collection includes parameters recorded during surgery and postoperative creatinine values. Participants will undergo cardiac surgery with CPB, during which relevant physiological data will be continuously recorded by specialized monitors. After surgery, kidney function and other outcomes will be monitored for up to 48 hours, with extended follow-up for complications and mortality over 30 days. Researchers will analyze how well the MDPI predicts acute kidney injury and other clinical outcomes, aiming to incorporate the MDPI into real-time monitoring devices to guide therapeutic decisions during surgery.

This research focuses on kidney transplant patients to collect blood samples and clinical data for developing a non-invasive test that detects donor-derived cell-free DNA dd-cfDNA to assess the condition of transplanted kidneys. The study is prospective and multicenter, involving participants who have had a kidney transplant and are undergoing an indication biopsy. The goal is to improve monitoring of the transplanted organs status. Participants will provide whole blood samples at the time of their indication biopsy, before the biopsy procedure itself. Additionally, leftover de-identified retrospective genomic DNA gDNA samples from the kidney donors will be collected for paired analysis. This approach helps researchers study dd-cfDNA in a real-world transplant population. Participants will be involved through blood sample collection and clinical data gathering during their biopsy visits. Researchers will monitor the detection of donor-derived cell-free DNA in whole blood over an 18-month period. The study involves no investigational treatments, focusing on observation and sample analysis. Participation duration and follow-up details align with the biopsy schedule and sample collection requirements.

Researchers are evaluating a new care approach for adults hospitalized with acute kidney injury AKI. This study compares a multimodal intervention to usual care to see if it increases the number of days patients spend out of the hospital within 90 days after discharge. The study also looks at effects on major kidney problems, repeat AKI episodes, and patient-reported health outcomes over up to one year. The intervention includes three parts a study doctor reviews the patient at hospital discharge and makes follow-up recommendations a nurse navigator provides kidney disease education, coordinates care, and monitors symptoms and a pharmacist reviews medications to avoid kidney-harming drugs and ensure proper dosing. Participants in the usual care group receive written information about kidney health and the importance of follow-up but do not get the extra support from the study team. Participants will be monitored through follow-up visits to track hospital-free days over 90 days, rates of major kidney events and recurrent AKI up to 180 and 365 days, and changes in quality of life and social support. The study collects patient-reported outcomes at several time points to understand the impact of the care approach. The total study duration for each participant is about one year, with assessments conducted remotely or in person as needed.