Angiotensin 2 for Hepatorenal Syndrome
NCT04048707 · Status: WITHDRAWN · Phase: PHASE2 · Type: INTERVENTIONAL
Last updated 2024-03-06
Summary
Hepatorenal syndrome (HRS) is a disease in which patients with cirrhosis (end stage liver failure) develop secondary kidney injury and failure. The current treatment available in the United States is a combination of octreotide and midodrine, which are meant to decrease the release of those hormones and raise the blood pressure, respectively, which would increase blood flow to the kidneys. Angiotensin 2 (Ang2) is a new vasopressor drug that was approved by the FDA in December 2017 for patients with low blood pressure and has been shown to have similar effects to octreotide and midodrine.
This study will investigate whether Ang2 reverses HRS among patients admitted to the intensive care unit (ICU) at Ronald Reagan Medical Center. Our study population will be patients with HRS who are already or will be admitted to the ICU. HRS will be defined by new internationally accepted guidelines published by the International Club of Ascites. All patients who are consented will undergo an Ang2 response trial, where low-dose Ang2 will be administered for 4 hours to see how the patients respond. This will help us characterize the nature of the patients' kidney failure for later analysis. Patients will then be randomized into the control group or the study group. Patients in the control group will receive octreotide (a subcutaneous injection) and midodrine (an oral drug). Patients in the study group will continue receiving intravenous infusion of Ang2. Patients in both groups will also receive albumin, a protein found commonly in human blood. Treatment will continue in both groups for four days, until complete reversal of HRS, dialysis, or death.
Our primary outcome will be rate of reversal of HRS, defined as improvement in kidney function.
Conditions
- Hepatorenal Syndrome
- Cirrhosis
- Kidney Failure, Acute
Interventions
- DRUG
-
Angiotensin II
Intravenous
- DRUG
-
Midodrine
Pill
- DRUG
-
Octreotide
Subcutaneous
- DRUG
-
Albumin solution
Intravenous suspension
Sponsors & Collaborators
-
University of California, Los Angeles
lead OTHER
Study Design
- Allocation
- RANDOMIZED
- Purpose
- TREATMENT
- Masking
- NONE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2021-07-01
- Primary Completion
- 2023-06-30
- Completion
- 2023-07-01
- FDA Drug
- Yes
More Related Trials
-
To Compare the Efficacy of Nor Adrenaline and Terlipressin vs Step up Terlipressin Therapy in Hepatorenal Syndrome
NCT01649037 ·Status: WITHDRAWN ·Phase: NA
-
Study of Terlipressin Versus Placebo to Treat Hepatorenal Syndrome Type 1
NCT00089570 ·Status: COMPLETED ·Phase: PHASE3
-
Nor-epinephrine Versus Midodrine/Octreotide in Patients With Hepatorenal Syndrome
NCT04522297 ·Status: COMPLETED ·Phase: NA
-
Terlipressin for HRS-AKI in Liver Transplant Candidates (INFUSE)
NCT04460560 ·Status: COMPLETED ·Phase: PHASE3
-
Terlipressin Infusion Alone Vs Terlipressin With Noradrenaline Infusion In The Treatment of Hepatorenal Syndrome Type 1
NCT03822091 ·Status: COMPLETED ·Phase: PHASE3
-
A Retrospective Analysis of Outcomes in Patients With Hepatorenal Syndrome at Methodist Dallas Medical Center
NCT06095440 ·Status: RECRUITING
-
Treatment of Hepatorenal Syndrome With Terlipressin Plus Albumin vs Albumin
NCT00287664 ·Status: SUSPENDED ·Phase: PHASE4
-
A Phase 1 Study of LJPC-501 in Patients With Hepatorenal Syndrome
NCT01906307 ·Status: TERMINATED ·Phase: PHASE1
-
RAI & HRS: Relationship Between Relative Adrenal Insufficiency and Failure of Treatment in Hepatorenal Syndrome
NCT04273750 ·Status: COMPLETED
-
Human Albumin for the Treatment of Ascites in Patients With Hepatic Cirrhosis
NCT01288794 ·Status: COMPLETED ·Phase: PHASE4
-
Treatment of Hepatorenal Syndrome With Terlipressin Infusion Adjusted to Hemodynamic Response
NCT01530711 ·Status: UNKNOWN ·Phase: PHASE4
-
To Compare the Response Rate of Noradrenaline vs. Terlipressin in Hepatorenal Syndrome in Patients With Acute on Chronic Liver Failure
NCT02573727 ·Status: COMPLETED ·Phase: NA
-
Empagliflozin in Diuretic Refractory Ascites
NCT05013502 ·Status: COMPLETED ·Phase: PHASE1
-
Renal and Cardiovascular Effects of Terlipressin in Patients With Cirrhosis and Ascites
NCT00115947 ·Status: COMPLETED ·Phase: PHASE2/PHASE3
-
Continuous Infusion Terlipressin for Patients With Cirrhosis and Refractory Ascites
NCT03107091 ·Status: COMPLETED ·Phase: PHASE2
-
Mechanism and the Effect of Midodrine on Portal Pressures in Patients With Cirrhosis
NCT01331785 ·Status: WITHDRAWN ·Phase: NA
-
Role Of Angiogenic Factors In The Development Of Hepatorenal Syndrome
NCT00734136 ·Status: TERMINATED ·Phase: NA
-
Treatment of Type I Hepatorenal Syndrome (HRS) With Pentoxyfylline
NCT02123576 ·Status: TERMINATED ·Phase: NA
-
Study to Evaluate the Efficacy of Intravenous Administration of Human Albumin Versus Saline Solution in Patients With descompénsate Cirrhosis Grade 1B or Higher Renal Failure
NCT07270874 ·Status: NOT_YET_RECRUITING ·Phase: PHASE4
-
The Selective Cytopheretic Device (SCD) for Acute Kidney Injury (AKI) and Hepatorenal Syndrome (HRS) Type I
NCT04898010 ·Status: SUSPENDED ·Phase: NA
-
Endothelin Receptor Antagonism With Ambrisentan to Treat Hepatorenal Syndrome
NCT06256432 ·Status: ACTIVE_NOT_RECRUITING ·Phase: PHASE2
-
Effects of Treatment of Ascites by the ALFApump System on Renal and Circulatory Function
NCT01438970 ·Status: UNKNOWN ·Phase: PHASE2
-
Terlipressin Given As I.V. Boluses Versus Terlipressin Given As Continuous Intravenous Infusion In Patients With Cirrhosis And Type 1 Hepatorenal Syndrome
NCT00742690 ·Status: UNKNOWN ·Phase: PHASE2/PHASE3
-
Efficacy of Early Terlipressin Plus Albumin Therapy in Comparison to Standard Treatment for HRS-AKI in Acute-on-chronic Liver Failure.
NCT04416282 ·Status: COMPLETED ·Phase: NA
-
The Influence of Paracentesis on Intra-abdominal Pressure and Kidney Function in Critically Ill Patients With Liver Cirrhosis and Ascites: an Observational Study
NCT01091233 ·Status: WITHDRAWN