Changes of Renal Resistive Index in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy.

NCT06174610 | Recruiting

• 1 other identifier: RICRRT_USK
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the study is to determine whether there is a correlation between changes in the renal resistive index and the restoration of kidney function in critically ill patients undergoing continuous renal replacement therapy.

Conditions

Acute Kidney Injury

Keywords

Acute Kidney Injury (AKI); Continous Renal Replacement Therapy (CRRT); Critical Care; Renal Resistive Index (RRI)

Outcome Measures

Primary Outcomes (1)

• Relationship between changes in RRI and recovery of kidney function

  The first ultrasound examination should be performed before the initiation of CRRT and, if not possible, within 24 hours of starting CRRT. Subsequently, the renal arteries will be assessed once a day during CRRT and after its completion until kidney function improves or there is a need for a return to renal replacement therapy. The return of kidney function is defined as a stable (increase \<0.3 mg/dl/24h) or decreasing serum creatinine level in two consecutive tests conducted at intervals of at least 24 hours and an average hourly diuresis \>0.5 ml/kg over the last 12 hours, with or without loop diuretics.

  on average from 1 to 3 weeks

Study Arms (1)

Acute Kidney Injury + CRRT

Critically ill patients admitted to the intensive care unit (ICU), undergoing continuous renal replacement therapy due to Acute Kidney Injury. Diagnostic Test: Daily Doppler measurement of Renal Resistive Index

Diagnostic Test: Measurement of Renal Resistive Index

Interventions

Measurement of Renal Resistive Index DIAGNOSTIC_TEST

The kidneys are preliminarily visualized in a 2D projection, followed by identifying interlobar or arcuate vessels using color Doppler. Flow measurements in these vessels are performed using pulsed-wave Doppler. Renal Resistive Index is determined over three cardiac cycles (five in the case of atrial fibrillation) in two different arteries, each in a different kidney section. Subsequently, measurements from each artery are averaged. If possible, the examination should be conducted bilaterally. The investigators do not have access to previous measurements (each study is recorded on a separate card).

Acute Kidney Injury + CRRT

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Adult ICU patients undergoing CRRT due to AKI

You may qualify if:

• All ICU patients undergoing CRRT due to AKI

You may not qualify if:

• age \<18 years
• pregnancy
• history of chronic kidney disease in stage 4 or 5
• post-kidney transplant status
• mechanical circulatory support
• occurrence of one or more conditions preventing reliable RRI measurement in both kidneys:
• challenging technical conditions of ultrasound examination, hindering proper visualization of the kidney
• post-kidney injury in grade III and higher, according to AAST
• advanced parenchymal kidney pathology: atrophy, hypoplasia, cirrhosis, extensive ischemia (more than 2/3 of the parenchyma),
• kidney diseases preventing parenchyma identification: advanced cancer (stage above T1 according to TNM), certain forms of polycystic kidney disease
• inflammatory kidney diseases
• obstructive uropathy
• renal vascular pathologies: renal vein thrombosis, significant stenosis (\>60%), and renal artery occlusion.

Sponsors & Collaborators

• Uniwersytecki Szpital Kliniczny w Opolu: lead

Study Sites (1)

Department of Anesthesiology and Intensive Care, Uniwersytecki Szpital Kliniczny w Opolu

Opole, Opole Voivodeship, 45-372, Poland

RECRUITING

Related Publications (5)

• Patriquin HB, O'Regan S, Robitaille P, Paltiel H. Hemolytic-uremic syndrome: intrarenal arterial Doppler patterns as a useful guide to therapy. Radiology. 1989 Sep;172(3):625-8. doi: 10.1148/radiology.172.3.2672090.

  PMID: 2672090 BACKGROUND

• Katulka RJ, Al Saadon A, Sebastianski M, Featherstone R, Vandermeer B, Silver SA, Gibney RTN, Bagshaw SM, Rewa OG. Determining the optimal time for liberation from renal replacement therapy in critically ill patients: a systematic review and meta-analysis (DOnE RRT). Crit Care. 2020 Feb 13;24(1):50. doi: 10.1186/s13054-020-2751-8.

  PMID: 32054522 BACKGROUND

• Fernandez SN, Santiago MJ, Gonzalez R, Lopez J, Solana MJ, Urbano J, Lopez-Herce J. Changes in hemodynamics, renal blood flow and urine output during continuous renal replacement therapies. Sci Rep. 2020 Nov 27;10(1):20797. doi: 10.1038/s41598-020-77435-x.

  PMID: 33247145 BACKGROUND

• Fernandez SN, Lopez J, Gonzalez R, Solana MJ, Urbano J, Aguado A, Lancharro A, Lopez-Herce J, Santiago MJ. Doppler ultrasound in the assessment of renal perfusion before and during continuous kidney replacement therapy in the pediatric intensive care unit. Pediatr Nephrol. 2022 Dec;37(12):3205-3213. doi: 10.1007/s00467-022-05428-1. Epub 2022 Mar 14.

  PMID: 35286455 BACKGROUND

• Ninet S, Schnell D, Dewitte A, Zeni F, Meziani F, Darmon M. Doppler-based renal resistive index for prediction of renal dysfunction reversibility: A systematic review and meta-analysis. J Crit Care. 2015 Jun;30(3):629-35. doi: 10.1016/j.jcrc.2015.02.008. Epub 2015 Feb 24.

  PMID: 25746587 BACKGROUND

MeSH Terms

Conditions

Acute Kidney Injury

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 1, 2023
• First Posted: December 18, 2023
• Study Start: December 19, 2023
• Primary Completion (Estimated): May 21, 2026
• Study Completion (Estimated): December 18, 2026
• Last Updated: June 3, 2025

Record last verified: 2025-05

Locations

PL (1)