SCD for CRS in Congestive Heart Failure (CHF) (No Left Ventricular Assist Device)

NCT04589065 | Suspended DMC FDA Device

• 1 other identifier: HUM00178335
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this clinical trial is to see if a new device (SCD) is safe and if it can reduce damage to the kidney enough to allow medications to work to improve heart and kidney function for use in patients that have moderate to severe heart failure and is at least in part due to heart failure and it not responding to standard medical therapy. The SCD is a cartridge used with a commercial hemodialysis unit. Participants will be enrolled in the clinical trial once eligibility is confirmed. In addition to clinical assessments and laboratory testing participants will have surface echocardiograms during the trial. The SCD treatment will take place for 4 hours on day 1, 3, and 5 while on hemodialysis.

Conditions

Heart Failure; Chronic Systolic Heart Failure; Renal Failure; Cardiorenal Syndrome

Keywords

Hospitalized

Outcome Measures

Primary Outcomes (1)

• Improvement in Cardiac Function - Left Ventricular Ejection Fraction

  This will be assessed by surface echocardiography.

  up to 4 weeks following last SCD treatment

Secondary Outcomes (2)

• Improved renal function as measured by serum creatinine

  up to 4 weeks following the last SCD therapy

• Improved renal function as measured by blood urea nitrogen (BUN)

  up to 4 weeks following the last SCD therapy

Study Arms (1)

Selective Cytopheretic Device

EXPERIMENTAL

Device: Selective Cytopheretic Device

Interventions

Selective Cytopheretic Device DEVICE

SCD therapy will take place for 4 hours on day 1, 3, and 5 while on hemodialysis treatment. Participants will be continue to be followed until 30 days after the last SCD treatment.

Selective Cytopheretic Device

Eligibility Criteria

• Age: 21 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Primary hospitalization for acute decompensated chronic systolic heart failure as defined:
• Left ventricular ejection fraction ≤35% as confirmed by baseline imaging procedure.
• New York Heart Association (NYHA) class III or IV chronic (≤ 90 days) systolic heart failure, with failure to respond to optimal medical therapy (beta blocker, Angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blockers (ARB) or valsartan/sacubitril, aldosterone antagonist, unless not tolerated or contraindicated, and loop diuretic, as needed) for 45 of the last 60 days.
• Baseline Estimated Glomerular Filtration Rate (eGFR)\*\* ≥ 40 ml/min/1.73 m2 (baseline defined as the highest known eGFR within 90 days of study enrollment)
• Worsening renal failure (WRF), defined for the purposes of this study as increase serum creatinine ≥ 0.5 mg/dL from baseline (baseline defined as the lowest known serum creatinine within 90 days of study enrollment)
• Cardiorenal syndrome is the most likely explanation for WRF
• Persistent signs and /or symptoms of congestion (peripheral edema, dyspnea, pulmonary rales, neck vein distension) despite optimal medical therapy including intravenous diuretic therapy and an estimated need for greater than 5 kg. of fluid removal. For the purposes of this study, optimal intravenous diuretic therapy is defined as:
• Furosemide equivalent total daily dose of 240 mg (furosemide 40mg=1mg bumetanide)
• Furosemide equivalent dose given either as a single or multiple intravenous bolus or continuous infusion
• A furosemide equivalent total daily dose \<240 mg if the dose has resulted in \>3000 ml urine output/24 hours

You may not qualify if:

• Prior sensitivity to dialysis device components
• Individual with known hypersensitivity to citrate
• Bacteremia or possible infection, as evidence by fever, white blood cell count \> 10,000/microliter, or any other signs of acute or chronic infection, and any patient receiving antibiotic or antiviral therapy.
• Active malignancy requiring chemotherapy, biological therapy or radiation therapy.
• The use of intravenous iodinated contrast agent within the prior 72 hours or the anticipated use of such an agent during SCD therapy.
• Persistent systolic blood pressure (SBP) \< 80 mmHg.
• White blood cell (WBC)\<4000/microliter.
• Platelets \< 50,000/microliter.
• Serum creatinine \> 4 mg/dL or receiving dialysis / continuous renal replacement therapy (CRRT)
• Acute coronary syndrome within the past month.
• Women who are pregnant, breastfeeding a child, or trying to become pregnant.
• Subject not able to sign informed consent.
• Use of any other investigational drug or device within the previous 30 days
• Concurrent enrollment in another interventional clinical trial. Patients enrolled in clinical studies where only measurements and/or samples are taken (i.e., no test device or test drug used) are allowed to participate.

Sponsors & Collaborators

• Lenar Yessayan: lead

Study Sites (1)

University of Michigan

Ann Arbor, Michigan, 48109, United States

Location

MeSH Terms

Conditions

Heart Failure; Renal Insufficiency; Cardio-Renal Syndrome

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Officials

• Keith Aaronson, MD

  University of Michigan

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor of Medicine

Study Record Dates

• First Submitted: October 8, 2020
• First Posted: October 19, 2020
• Study Start: September 1, 2025
• Primary Completion (Estimated): December 1, 2027
• Study Completion (Estimated): December 1, 2027
• Last Updated: September 27, 2024

Record last verified: 2024-09

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)