RecruitingNot ApplicableNCT06446739

LoW Dose-Intensity vs. Standard Dose-Intensity COntinuous Renal ReplaceMent Therapy in Critically Ill Patients (WISDOM)

LoW Dose-Intensity vs. Standard Dose-Intensity COntinuous Renal ReplaceMent Therapy in Critically Ill Patients (WISDOM): A Pilot Randomized Trial

Sponsor

University of Alberta

Enrollment

100 participants

Start Date

Nov 14, 2024

Study Type

INTERVENTIONAL

Conditions

Acute Kidney Injury Dialysis; Complications

Summary

An estimated 10-15% of critically ill patients with acute kidney failure in the intensive care unit receive acute dialysis therapy. The majority of these patients initially receive a continuous form of dialysis therapy call continuous renal replacement therapy (CRRT). Prior studies have suggested that higher CRRT dose-intensity improved health outcomes for these patients; however, this was not found in high-quality clinical trials. These more recent trials suggested a lower range of dose-intensity compared with the higher range as the new standard of care. This was incorporated into guidelines. To date, no clinical trials have evaluated this lower range and specifically, it is plausible that an even lower dose-intensity of CRRT may be well tolerated, safe, associated with similar outcomes and be more cost-effective. This is the objective of the WISDOM trial, to compare the guideline standard with lower dose-intensity among patients who are started on CRRT in the intensive care unit.

Eligibility

Min Age: 18 Years

Inclusion Criteria5

age ≥ 18 years
weight ≥ 55 kg
plan to initiate CRRT or within 24 hours of having started CRRT for AKI
expected to survive and receive CRRT for a duration of ≥ 48 hours
able to provide informed consent or have an authorized representative provide consent after being informed on the details and risks of the trial unless a deferred consent process is approved by local Research Ethics Board (REB).

Exclusion Criteria4

indication for sustained higher dose-intensity CRRT as designated by the attending clinicians
end-stage kidney disease receiving maintenance dialysis
receipt of any RRT for AKI during the current hospitalization
inability to comply with the requirements of the study protocol.

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Interventions

DEVICEContinuous Renal Replacement Therapy (CRRT)

Continuous Renal Replacement Therapy (CRRT) is a continuous form of acute renal replacement (hemofiltration/dialysis) therapy provided to critically ill patients with multi-organ dysfunction receiving life support in the intensive care unit (ICU).