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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03251131
Registration number
NCT03251131
Ethics application status
Date submitted
12/08/2017
Date registered
16/08/2017
Date last updated
14/12/2020
Titles & IDs
Public title
REVERSE-AKI Randomized Controlled Pilot Trial
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Scientific title
REstricted Fluid Therapy VERsus Standard trEatment in Acute Kidney Injury - REVERSE-AKI Randomized Controlled Pilot Trial
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Secondary ID [1]
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HUS/1782/2017
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Universal Trial Number (UTN)
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Trial acronym
REVERSE-AKI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Kidney Injury
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Critical Illness
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Condition category
Condition code
Renal and Urogenital
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Kidney disease
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Injuries and Accidents
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Other injuries and accidents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Restrictive fluid management
Experimental: Restrictive fluid management - Restrictive fluid management Targeting a negative or maximum 300ml positive daily fluid balance.
No intervention: Standard therapy - Randomized allocation of standard care at the clinician's discretion in accordance with current best practice.
Other interventions: Restrictive fluid management
Daily fluid input is restricted to drugs and nutrition. Fluid boluses and blood products can be given if clinically indicated. Matching fluid output to fluid input whenever possible using diuretics if needed, and additionally, if clinically necessary and plausible, commencing renal replacement therapy. If renal replacement therapy is not deemed clinically desirable, acceptance of a less than targeted fluid balance.
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Intervention code [1]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Cumulative fluid balance
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Assessment method [1]
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Timepoint [1]
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72 hours
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Secondary outcome [1]
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Duration of acute kidney injury
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Assessment method [1]
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Defined according to Kidney Disease: Improving Global Outcomes criteria
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Timepoint [1]
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ICU discharge/14 days
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Secondary outcome [2]
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Number of patients requiring renal replacement therapy
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Assessment method [2]
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Timepoint [2]
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14 days
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Secondary outcome [3]
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Cumulative fluid balance
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Assessment method [3]
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Timepoint [3]
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24 hours
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Secondary outcome [4]
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Cumulative fluid balance
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Assessment method [4]
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Timepoint [4]
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ICU discharge/ 7 days
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Secondary outcome [5]
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Cumulative dose of diuretics
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Assessment method [5]
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Timepoint [5]
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ICU discharge/ 7 days
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Eligibility
Key inclusion criteria
1. 18-years or older and admitted to critical care with an arterial line in place
2. The patient has been in critical care for at least 12 hours but no more than 72 hours
3. The patient has AKI but is not receiving acute RRT:
For the purpose of the study AKI is defined the by the following criteria:
1. Increase in serum creatinine over 1.5-times above baseline without a decline of 27umol/l or more from the last preceding measurement (at least 12 hours apart) AND/OR
2. Overall urine output less than 0.5ml/kg/h (or 6ml/kg) for the previous 12h (with urine catheter in place for the period)
4. The patient is judged by the treating clinician not to be intravascularly hypovolemic
5. The patient is likely to remain in critical care for 48 hours after randomization
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Active bleeding necessitating transfusion
2. Maintenance fluid therapy is necessary due to diabetic ketoacidosis, non-ketotic coma, severe burns or other clinical reason determined by the medical staff
3. Need for RRT due to intoxication of a dialyzable toxin
4. Commencement of RRT is expected in the next 6 hours
5. On chronic renal replacement therapy (maintenance dialysis or renal transplant)
6. Presence or a strong clinical suspicion of parenchymal AKI (for example glomerulonephritis, vasculitis, acute interstitial nephritis), or post-renal obstruction
7. Severe hyponatremia (Na <125mmol/L) or hypernatremia (Na >155mmol/L)
8. Need for extracorporeal membrane oxygenation or molecular absorbent recirculating system (MARS-therapy)
9. Pregnant or lactating
10. Patients who are not to receive full active treatment
11. No baseline creatinine available
12. Lack of consent
13. The patient has been enrolled in another trial where co-enrollment is not feasible
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
8/11/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
30/04/2020
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Sample size
Target
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Accrual to date
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Final
100
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Austin Hospital - Melbourne
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Recruitment hospital [2]
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Canberra Hospital - Canberra
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Recruitment postcode(s) [1]
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3048 - Melbourne
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Recruitment postcode(s) [2]
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- Canberra
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Recruitment outside Australia
Country [1]
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Belgium
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State/province [1]
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Ghent
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Country [2]
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Finland
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State/province [2]
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Helsinki
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Country [3]
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Switzerland
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State/province [3]
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Lausanne
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Country [4]
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United Kingdom
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State/province [4]
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London
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Funding & Sponsors
Primary sponsor type
Other
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Name
Helsinki University Central Hospital
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Address
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Other collaborator category [1]
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Other
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Name [1]
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Austin Hospital, Melbourne Australia
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Guy's and St Thomas' NHS Foundation Trust
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Address [2]
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Other collaborator category [3]
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Other
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Name [3]
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University Hospital, Ghent
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Address [3]
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Other collaborator category [4]
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Other
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Name [4]
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Medical University Innsbruck
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Address [4]
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Other collaborator category [5]
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Other
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Name [5]
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Lausanne University Hospital
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Address [5]
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Country [5]
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Ethics approval
Ethics application status
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Summary
Brief summary
Observational studies among patients with acute kidney injury (AKI) have shown an association with fluid accumulation and increased mortality. Trials among other subgroups of critically ill patients have demonstrated that restricting fluid input after the initial resuscitation appears safe. The objective if this study is to determine whether a fluid restrictive treatment regimen will lead to a lower cumulative fluid balance at 72 hours from randomization in critically ill patients with AKI and whether this approach is safe and feasible.
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Trial website
https://clinicaltrials.gov/study/NCT03251131
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Trial related presentations / publications
Vaara ST, Ostermann M, Selander T, Bitker L, Schneider A, Poli E, Hoste E, Joannidis M, Zarbock A, van Haren F, Prowle J, Pettila V, Bellomo R. Protocol and statistical analysis plan for the REstricted fluid therapy VERsus Standard trEatment in Acute Kidney Injury-REVERSE-AKI randomized controlled pilot trial. Acta Anaesthesiol Scand. 2020 Jul;64(6):831-838. doi: 10.1111/aas.13557. Epub 2020 Feb 26.
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Public notes
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Contacts
Principal investigator
Name
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Suvi Vaara, MD, PhD
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Address
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Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Fax
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03251131
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