Comparing Intravenous and Oral Hydration to Prevent Kidney Injury After Contrast CT Scans in Adults With Severe Chronic Kidney Disease

What this Trial Is About

This research aims to compare intravenous IV hydration and oral hydration to prevent post-contrast acute kidney injury PC-AKI in patients with severe chronic kidney disease CKD who are scheduled for an elective contrast-enhanced CT scan CECT. The study focuses on patients with an estimated glomerular filtration rate eGFR below 30 mLmin1.73 m2, who are at high risk for PC-AKI, a kidney injury that can occur after contrast media use. It also evaluates biomarkers NGAL and cfDNA for early detection and prognosis of PC-AKI and related outcomes. Participants will be randomly assigned to receive either IV hydration with isotonic 0.9% NaCl or oral hydration with bottled water. IV hydration starts three hours before and ends four hours after the CT scan, typically with 1000 mL divided equally before and after the scan patients with heart failure receive a reduced volume of 500 mL. Oral hydration starts one to two hours before and completes within four hours after the scan, with similar volume adjustments. The study is an open-label, randomized controlled trial conducted at Odense University Hospital. During the study, patients will undergo blood and urine tests before, shortly after, and up to 30 days following the CT scan to monitor kidney function, biomarkers, and clinical outcomes including dialysis, hospitalization, and mortality. Follow-ups include medical interviews to assess CKD symptom progression. Patient data is collected via electronic health records and REDCap. Participants may leave the study anytime without consequences. The total follow-up period is 30 days post-CT scan with interim safety analyses planned.

Intravenous vs. Oral Hydration to Reduce the Risk of Post-Contrast Acute Kidney Injury After Intravenous Contrast-Enhanced Computed Tomography in Patients With Severe Chronic Kidney Disease