Comparison of Safety and Efficacy of Tailored Versus Fixed Dose Albumin for the Management of Patients With Cirrhosis and Sepsis Associated Acute Kidney Injury
NCT06809088 · Status: NOT_YET_RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 100
Last updated 2025-02-05
Summary
Acute kidney injury accompanies about 20% of hospitalized patients with cirrhosis and in about 40% of those admitted to ICU.A critically ill patient with cirrhosis refers to an individual who has advanced liver disease (cirrhosis) and is experiencing severe and potentially life-threatening complications that require intensive medical care and monitoring. These complications might include hepatic encephalopathy, acute liver failure, severe bleeding due to portal hypertension, or other organ failures. Such patients often require specialized medical attention and interventions to stabilize their condition. The short-term prognosis of cirrhotic patients with acute kidney injury is poor, with a mortality rate higher than 65% in patients with RRT requirement. Patients with cirrhosis are prone to develop AKI . HRS comprises specific form of AKI\[HRS-AKI\] in patients with advanced cirrhosis and ascites, carries a high mortality risk. Role of albumin as colloid serves both as volume supplement and also as additive to vasoconstrictors. Ascites, elevated bilirubin, spontaneous bacterial peritonitis \[SBP\] and use of amino glycosides antibiotics had previously been identified as significant risk factors for renal failure in cirrhotic patients. The causes of AKI in cirrhotic patients include HRS \[most common\], others include ATN \[associated mostly with sepsis\]and hypovolemic shock. Three month survival ranged from 73% in patients with parenchymatous AKI to 15% for HRS. As per 2023 joint meeting of ICA and ADQI ,based on baseline serum creatinine\[sCr\](a lowest value obtained within the previous 3 months),AKI is defined by an absolute increases of sCr\>=0.3mg/dl within 48hr or a percentage increase of sCr\>=50% from baseline within 7 days and urine output \<= 0.5ml/kg for \>=6hrs.As per KDIGO ,three stages of AKI are defined :Stage 1\]when the previous criteria are met \[a relative increase of sCr 1.5-2.0from baseline, stage 2\]when increase in sCr is \>2folds to 3 folds from baseline and Stage 3\]when there is an increase of sCr\>3 folds from baseline or sCr is \>4.0mg/dl with an acute increase of \>0.3mg/dl or initiation of RRT. So, the study aims to analyze the role of albumin as a volume supplement and as a vasoconstrictor as well as its immunomodulatory effect in sepsis to help in resolution of AKI.Here we compare the effectiveness of personalized-dose albumin administration with fixed-dose albumin for treating acute kidney injury in patients with cirrhosis and sepsis associated AKI.
Conditions
Interventions
- BIOLOGICAL
-
Albumin
Albumin
- OTHER
-
Standard Medical Treatment
Standard Medical Treatment
Sponsors & Collaborators
-
Institute of Liver and Biliary Sciences, India
lead OTHER
Study Design
- Allocation
- RANDOMIZED
- Purpose
- TREATMENT
- Masking
- NONE
- Model
- PARALLEL
Eligibility
- Min Age
- 18 Years
- Max Age
- 70 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2025-01-31
- Primary Completion
- 2026-01-31
- Completion
- 2026-01-31
Countries
- India
Study Locations
More Related Trials
-
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
-
Initial Resuscitation for Acute Kidney Injury in Cirrhosis
NCT06525623 ·Status: RECRUITING ·Phase: NA
-
Effects of Maintaining Steady Albumin Levels (TAT 4) on Survival and Liver Related Complications in Cirrhosis With Ascites
NCT04058613 ·Status: UNKNOWN ·Phase: NA
-
Albumin Infusion in Inpatients With Decompensated Cirrhosis
NCT05719051 ·Status: UNKNOWN
-
Albumin Assisted Diuresis in Patients with Cirrhosis and Ascites
NCT06812390 ·Status: RECRUITING ·Phase: PHASE2
-
To Evaluate the Safety and Efficacy of Preemptive Administration of Continuous Renal Replacement Therapy in Patients With Acute Liver Failure With Cerebral Edema
NCT04991259 ·Status: UNKNOWN ·Phase: NA
-
Assessment of Coagulation Profile and Haematopoietic Responses in Patients With Acute-on-chronic Liver Failure During Systemic Inflammatory Response (SIRS) and Sepsis
NCT02307409 ·Status: COMPLETED
-
Impact of Continuous Renal Replacement Therapy on Systemic Hemodynamics and Lactate Clearance in Critically Ill Cirrhotics With Septic Shock.
NCT04949178 ·Status: UNKNOWN
-
To Compare the Efficacy of Nor Adrenaline and Terlipressin vs Step up Terlipressin Therapy in Hepatorenal Syndrome
NCT01649037 ·Status: WITHDRAWN ·Phase: NA
-
Acute Hemodynamics of Albumin Versus Normal Saline in Cirrhosis
NCT00511394 ·Status: SUSPENDED ·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
-
Optimal Clinical Predictors to AKI in Cirrhotic Patients Experienced Acute Gastrointestinal Hemorrhage
NCT04184934 ·Status: UNKNOWN
-
Efficacy and Safety of Plasma Exchange Compared to Standard Medical Therapy in Patients With Severe Drug Induced Liver Injury With or Without Underlying Chronic Liver Disease.
NCT04015570 ·Status: UNKNOWN ·Phase: NA
-
Incidence and Predictors of Bleeding Diathesis Development Due to DIC in Cirrhosis and ACLF Patients Undergoing CRRT
NCT04960163 ·Status: UNKNOWN
-
Low-dose Albumin Solution in SBP: a Randomized Double-blind Pilot Study
NCT00852800 ·Status: UNKNOWN ·Phase: PHASE2
-
Efficacy of Vitamin C on AKI Outcomes in Critically Ill Cirrhotics With Multidrug-resistant Bacterial Infections.
NCT04494451 ·Status: COMPLETED ·Phase: NA
-
The Selective Cytopheretic Device (SCD) for Acute Kidney Injury (AKI) and Hepatorenal Syndrome (HRS) Type I
NCT04898010 ·Status: SUSPENDED ·Phase: NA
-
Coagulation Parameters With Albumin in Decompensated Cirrhosis (CoPA-D).
NCT05937048 ·Status: COMPLETED ·Phase: NA
-
Evaluation of Low-dose Albumin and Midodrine Versus Midodrine Alone in Outcome of Recurrent Ascites in Patients With Decompensated Cirrhosis.
NCT06245590 ·Status: UNKNOWN ·Phase: NA
-
High-Volume Plasma Exchange Versus Standard Medical Treatment in Patients With Acute Liver Failure
NCT02718079 ·Status: COMPLETED ·Phase: NA
-
An Open-label Randomized Controlled Trial Comparing the Role of Therapeutic Plasma-exchange in Ameliorating Secondary Organ Dysfunctions in Patients With ACLF and Develop Biomarkers of Treatment Response
NCT06276907 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
To Study the Clinical Course and Outcomes of Non-electively Hospitalised Patients of Chronic Liver Disease (CLD) With Hepatic or Extra-hepatic Predominant Organ Failure(s) at 6 Months.
NCT07270809 ·Status: NOT_YET_RECRUITING
-
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
-
High Versus Low Target Mean Arterial Pressure in Septic Shock in Critically Ill Cirrhotics
NCT03145168 ·Status: COMPLETED ·Phase: NA
-
Evaluation of Albumin and Midodrine Versus Albumin Alone in Outcome of Refractory Ascites in Patients With Decompensated Cirrhosis.
NCT04816240 ·Status: UNKNOWN ·Phase: NA