Clinical Trials Logo

Clinical Trial Summary

Acute Renal Failure (ARF) is defined by a severe, and usually reversible, glomerular filtration rate decreasing. Acute Tubular Necrosis (ATN) remain the major cause of ARF involving distress and destruction of tubular cells. This specific typology of ARF may evolve toward Chronic Renal Failure (CRF) concretizing a major public health issue.

Predict the progression of ARF towards CRF appears essential. The investigators believe that the PIIINP and urinary NGAL biomarkers may constitute robust biomarkers of progression risk towards CRF.


Clinical Trial Description

Acute Renal Failure (ARF) is defined by a severe, and usually reversible, glomerular filtration rate decreasing. Beside its frequency, ARF may be associated with severe prognostic. Thus, patient admitted in ICU and suffering of ARF requiring dialysis, had a higher risk of mortality up to 50%.

Tubulointerstitial nephropathies, particularly Acute Tubular Necrosis (ATN) remain the major cause of ARF, representing 45-50% of cases. The ATN is due to suffering and destruction of tubular cells which are very sensitive to ischemia-reperfusion lesions because tubular reabsorption functions require significant and constant energy intake. However, ATN represents a relatively homogeneous group in terms of acute kidney disease typology. Homogeneity and significant frequency compels ATN as an optimal model to study function recovery after ARF.

ARF constitutes a major public health issue. Actually, incidence of Chronic Renal Failure (CRF) after an ARF, due to ATN, is estimated between 19% and 31%. In addition 12.5% of patients with specific ARF presentation immediately reach End-stage Renal Disease (ESRD), and the occurrence of ARF requiring dialysis, triples the risk of chronic renal support.

Therefore, predict the progression of ARF towards CRF appears essential.

At this time, the investigators currently lack of reliable biomarkers to predict such progression. This pejorative kidney development is due to the persistence of intrarenal inflammation, rapid development of interstitial fibrosis and deficiency in tubular restoration. It involves complex mechanisms of inflammatory response, and vascular and tubular remodeling.

Two promising biomarkers of renal fibrosis, ARF occurrence and CRF progression risk appear in recent years: the Procollagen III N-terminal peptide (PIIINP) and the neutrophil gelatinase associated lipocalin (NGAL). The investigators believe that the PIIINP and urinary NGAL may constitute robust biomarkers of progression (or not) towards CRF in ARF context. Firstly, PIIINP is a good reflection of fibrosis process inside the kidney. Secondarily, NGAL is a marker of renal tubule remodeling after renal aggression. The combination of these two biomarkers could therefore efficiently reflect the balance tubular fibrosis/restoration and may allow optimal prediction of renal function recovery.

The investigators hypothesize that these two biomarkers may be used to assess the risk of CRF progression during ARF in ATN context. ;


Study Design

Observational Model: Cohort, Time Perspective: Prospective


Related Conditions & MeSH terms


NCT number NCT02889575
Study type Observational
Source Nantes University Hospital
Contact
Status Completed
Phase N/A
Start date April 2012
Completion date February 2016

See also
  Status Clinical Trial Phase
Completed NCT01946113 - Mineral-Homeostasis in Continuous Renal Replacement Therapy N/A
Completed NCT01476995 - Prognostic Indicators as Provided by the EPIC ClearView N/A
Withdrawn NCT00993733 - Assessing the Impact of Two Methods of Continuous Veno-venous Hemodiafiltration on Time Nursing Work in Intensive Care N/A
Terminated NCT00978354 - Furosemide in Early Acute Kidney Injury Phase 2/Phase 3
Completed NCT00120263 - Trial of Plasma Exchange for Acute Renal Failure at the Onset of Myeloma N/A
Completed NCT04799600 - The Effect of the Severity of COVID-19 Disease on the Incidence of Acute Renal Failure in ICU
Recruiting NCT04334707 - Kidney Precision Medicine Project
Completed NCT02858531 - Predictive Tracking of Patient Flow in the Emergency Services During the Virus Winter Epidemics
Recruiting NCT05282732 - Retrospective Analysis of Performance and Treatment Data Collected for Genius SleddFlux Filter, Ultraflux AV 600 S Filter & Genius 90 Concentrates in Haemodialysis Patients
Completed NCT01467466 - Prevention of Serious Adverse Events Following Angiography Phase 3
Completed NCT01979042 - Urinary Markers for Unilateral Kidney Obstruction N/A
Completed NCT01280617 - Low Dose Thymoglobin in Renal Transplant Patients N/A
Completed NCT00780351 - Dosing Vancomycin in Patients on Sustained Low Efficiency Daily Hemodiafiltration (SLEDD-f) N/A
Completed NCT00971971 - Prevention of Intradialytic Hypotension in Acute Kidney Injury Patients N/A
Completed NCT00076219 - Acute Renal Failure Trial Network (ATN) Study Phase 3
Recruiting NCT04599569 - Influence of Renal Replacement TherApy on Indirect Calorimetry
Completed NCT03727204 - Acute Kidney Injury After Cardiac Surgery: Novel Ultrasound Techniques for Prediction of Acute Kidney Injury
Completed NCT06005896 - A Clinical Model for Dialysis Discontinuation in AKI
Completed NCT03004950 - Biomarker Effectiveness Analysis in Contrast Nephropathy (BEACON)
Completed NCT03627884 - Outcomes of the Use of Sodium Bicarbonate (8.4%) Solution as a Catheter Lock Solution to Prevent Hemodialysis Catheter Loss Due to Lumen Clot Formation Phase 4