Acute Renal effects of Angiotensin II Management In Shock (ARAMIS-2)

This Phase 2 randomised controlled trial (ARAMIS-2) is testing whether angiotensin II — a naturally occurring hormone that constricts blood vessels — can improve kidney outcomes in critically ill patients with vasodilatory shock. Vasodilatory shock occurs when blood vessels throughout the body become dangerously dilated (often in sepsis), causing blood pressure to fall so low that organs like the kidneys are not getting enough blood flow. Current treatment relies on drugs like noradrenaline to squeeze the blood vessels. Previous research suggested that angiotensin II may be particularly beneficial for patients who already have acute kidney injury. Patients in the ICU with vasodilatory shock will be randomly assigned to receive either angiotensin II or noradrenaline via continuous IV infusion until their shock resolves. Kidney function and survival outcomes will be closely compared between the two groups. To be eligible, you must be an adult (18 or older) in the ICU with low blood pressure from vasodilatory shock, have central IV access and a urinary catheter in place, and be expected to need blood pressure support for at least 24 hours. Patients who are post-cardiac surgery, have been on noradrenaline for more than 24 hours before enrolment, are on permanent dialysis, or are pregnant are not eligible. The study is run by the University of Queensland.