Cardiac Surgery Clinical Trial
Official title:
Renal Resistive Index Compared With NephroCheckTM to Predict Postoperative Acute Renal Failure in Patients Undergoing Cardiac Surgery.
Postoperative acute renal failure is a frequent complication after cardiac surgery. The
current practice cannot predict Acute Kidney Injuries (AKI) early enough to reduce a
significant kidney assault and prevent an organic dysfunction leading to cortical tubular
necrosis.
Several recent studies in cardiac surgery have shown that, both sonographic criteria, such
as the Renal Resistive Index (IRR) and urinary biomarkers can predict AKI promptly. These
urinary biomarkers are the 'tissue inhibitor of metalloproteinases' (TIMP-2) and the
'insulin-like growth factor binding protein' (IGFBP7). These two proteins are sought
noninvasively, directly in the urine, within the same test called 'NephroCheckTM'. These
markers, ultrasonographic and biologic, have the advantage of being easy to perform,
accessible and seem to have both high sensitivity and specificity to predict AKI promptly
after cardiac surgery. Thus, the IRR and the NephroCheckTM test could become essential tests
to guide clinicians in determining rapidly whether a patient will develop AKI. However, so
far, no study has compared these markers yet.
Therefore, the aim of this prospective observational study will be to compare the
effectiveness of the IRR with the NephroCheckTM to predict AKI promptly after cardiac
surgery. The secondary outcome will be to determine the threshold of these markers from
which patients will be likely to develop AKI
Status | Completed |
Enrollment | 51 |
Est. completion date | November 2014 |
Est. primary completion date | November 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Elective patients - Patients scheduled to receive an extracorporeal circulation - Patients aged 60 and older - Patients at risk of postoperative acute kidney injury presenting at least two of the following risk factors: - Age > 60 years. - Arteritis defined as severe lower limb arteriopathy or carotid stenosis > 50% - Diabetes - Valvular or combined surgery - Preoperative intra-aortic balloon pump. Exclusion Criteria: - Unable to provide informed consent - Comatose patients - Patients with dementia - Patient who underwent a previous sternotomy - Chronic renal failure (sCr clearance < 30 ml.min-1) - Renal artery stenosis - Endocarditis - Emergent surgery - Nephrotoxic treatment - Non-sinus cardiac rhythm |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
France | CHU de Bordeaux | Pessac | Bordeaux |
Lead Sponsor | Collaborator |
---|---|
University Hospital, Bordeaux |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Renal Resistive Index compared with NephroCheckTM | Compare the effectiveness of the IRR with the NephroCheckTM to predict AKI after cardiac surgery. AKI will be defined according to the RIFLE criteria. | Day 0 (inclusion) / after cardiac surgery | No |
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