Kidney Injury

Researchers are evaluating the effects of furosemide alone compared to furosemide combined with albumin in adult critically ill patients with fluid overload. The study aims to find out if adding albumin improves urine output and kidney function. The primary focus includes measuring urine output at 2 hours and examining changes in kidney blood flow markers and biochemical tests. Secondary measures include blood pressure, electrolyte levels, and kidney resistance patterns. Participants are randomly assigned to one of two groups: one receives a single intravenous dose of furosemide at 1 mg/kg infused over 30 minutes with a placebo saline infusion, while the other receives the same dose of furosemide combined with 50 grams of 25% albumin infused over 30 minutes. This double-blind trial ensures both groups are treated under similar controlled conditions to compare the treatments effectively. During the study, urine output is measured at 2 hours after treatment administration. Researchers also use bedside ultrasound to assess fluid overload and venous congestion, while monitoring blood pressure, electrolyte changes, and kidney function through blood and urine tests up to 24 hours. The study helps determine whether albumin enhances diuretic response and kidney health in this patient group. Participation lasts through these initial assessments and monitoring periods.

Researchers are evaluating the pharmacokinetics, or how the body processes, of one or two doses of the drug MK-2828 in people with kidney disease. The study aims to determine if the way MK-2828 behaves in individuals with certain types of kidney impairment is similar to that in healthy people. This research is a Phase 1 clinical trial focusing on participants with severe renal impairment, end-stage renal disease (ESRD), and healthy controls. Participants with severe renal impairment will receive a single oral dose of MK-2828 on Day 1. Those with ESRD on hemodialysis will receive a single dose in each of two study periods, separated by at least 14 days. Healthy participants with normal kidney function will receive a single dose on Day 1. The trial is open-label, meaning all participants and researchers know which treatment is given. During the study, participants will have blood samples collected before dosing and at various times up to 192 hours afterward to measure drug levels and related pharmacokinetic parameters. Those on hemodialysis will have additional assessments related to dialysis clearance. Safety will be monitored through tracking adverse events up to approximately 14 days. The study will continue until July 2026, with participants involved in a single-dose administration and follow-up sampling and observation.

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 Utah's 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 model's 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 model's 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 organ's 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 studying patients with acute kidney injury (AKI) to compare a new multimodal intervention with usual care. This trial aims to see if the intervention increases the number of days patients spend outside the hospital within 90 days after discharge. It also looks at whether the intervention lowers serious kidney complications, reduces repeat AKI episodes, and improves patient-reported health outcomes. The study will include 2,145 participants who are randomly assigned to one of the two groups, with randomization organized by clinical site. The study intervention combines three key elements: physician oversight with follow-up care recommendations at hospital discharge, support from a nurse navigator who educates patients and coordinates care, and a pharmacist-led review of medications to avoid kidney-harmful drugs and ensure proper dosing. Participants in the usual care group receive written information about kidney disease and the importance of follow-up but do not get additional support from the study team. Both groups will be followed up for 90 days to assess outcomes. During the trial, participants will have scheduled follow-up visits where researchers will collect data on hospital-free days as the main outcome. Secondary outcomes include rates of major adverse kidney events and recurrent AKI up to 180 days, along with assessments of quality of life, provider interactions, and social support up to 365 days. The study includes monitoring through patient questionnaires and clinical evaluations. Participants are expected to be involved for at least 90 days, with some outcomes tracked for up to one year after enrollment.