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Nicotinamide, also known as vitamin PP or as a vitamin B3 analog, has recently emerged as a key therapeutic drug to stop ATN and accelerate its recovery. In humans, NAM administered orally was shown to be safe in a phase I research and was associated with a 35% reduced risk of AKI in 41 high-risk cardiac surgery patients. In the phase III study, the GABRIEL study aims at determining its beneficial results in the context of DGF. On post-operative day 1 and day 2 respectively, the early kidney allograft function will be assessed on the creatinine reduction ratio between day 1 and 2 CRR2, where Cr1 and Cr2 are the morning serum creatinine. Before POD7, the aim is to verify the safety profile of NAM Evaluate the impact of NAM on the rate of delayed graft function, which is traditionally regarded as the need for dialysis. 3 months after transplantation, Evaluate the effects of NAM on renal graft function. Evaluate the effect of NAM on serum NAM levels Evaluate the impact of NAM on serum NAM levels Evaluate the effect of NAM on serum NAM levels Evaluate the impact of NAM on the biopsy-proven rejection rate within three months after transplantation. Evaluate the effect of NAM serum concentration at baseline on the risk of DGF risk at a young age. After initial enrollment and before transplantation, the patient will be completed by the patient at V0; for others, EQ5D questionnaires will be completed at POD7 and the last study visit M3.
Source link: https://clinicaltrials.gov/ct2/show/NCT05513807
During a portion of the liver transplant procedure, participants will be randomized to normothermia versus mild hypothermia. The protocol is based on preliminary results from rodent models demonstrating that hypothermia shields the kidneys from ischemia-reperfusion injury, as well as studies in deceased organ donors indicating that cooling enhances post-transplant organ function. After LTx, the investigators hypothesize that mild hypothermia will reduce the incidence and severity of AKI.
Source link: https://clinicaltrials.gov/ct2/show/NCT03534141
The sudden and immediate decrease in kidney function is caused by acute kidney injury. It's vital to know a patient's fluid status, as inadequate fluid intake can cause more kidney damage, while too much can be destructive. Assessment is inconsistent and often inaccurate, and there must be a common approach to fluid assessment. Aim: To create an Enhanced Fluid Assessment Tool for patients with AKI. AKI patients: Objective 1: To determine what methods are best to assess fluid in a patient with AKI. Aim: To determine fluid status in a patient with AKI The Workstream 1 results will be used to determine the most accurate fluid assessment methods. The terminology and terminology will be reviewed and the app will be used to assess patients and determine patients' fluid status.
Source link: https://clinicaltrials.gov/ct2/show/NCT05538351
Inclusion and exclusion criteria: After the study's approval by the local Ethical Committee, all adult patients admitted to UZ Leuven's ICU have been admitted to the hospital, and the study will be published before June 30th, 2018. The only exclusion criteria would be the presence of end-stage renal disease before or during AKI admission to ICU admission. Physicians' opinions: Physicians' predictions: Physicians' opinions will be collected alternatively by interviews conducted personally by one of the investigators or by means of a questionnaire developed by the physicians themselves. Interviews with multiple physicians about the same patient in the same time frame would be encouraged as long as they are not influenced by one another. Endpoint review The effective development of AKI would be determined in accordance with the 2012 KDIGO guidelines . Following ICU admission, Serum creatinine values would be collected from the electronic health record system KWS each day for 7 days. Both for the computer-based AKIpredictor and the ongoing assessment of AKI risk by the clinicians at each of the three time points will be plotted. The investigators should treat all details and data relating to the study as confidential, and they will not disclose such details or use such data for any other purpose other than the study's success. The collection, processing, and storage of personal data, including patient health and medical records, is subjected to regulation regarding personal data privacy and personal data processing.
Source link: https://clinicaltrials.gov/ct2/show/NCT03574896
Hospital lengths of stay and excess expenditures have been shown by increased hospital lengths and high costs in CA-AKI. Therefore, the prevention of CA-AKI is very beneficial in reducing hospital costs, mortality, and morbidity. Over the decades of preventative measures and therapies have failed to produce a consistent result. One of the objectives of antioxidant research and therapies in CIN prevention of CIN is to minimize the release of oxygen free radicals that are promoting CIN. The presence of a strong correlation between serum uric acid and acute kidney injury has been documented in studies. Urinc acid, a prooxidant in the extracellular environment and as a prooxidant in the intracellular environment in humans. Urc acid crystallizes and causes kidney Stones in the urinary tract for hundreds of years, according to historians. In some studies, a recent meta-analysis reported that Trimetazidine therapy may reduce the risk of CIN in patients undergoing coronary angiography or percutaneous coronary intervention. Trimetazidine reduced CIN occurrence in patients with moderate to high risk populations based on Mehran's score, but not in low-risk patients. According to our findings, we tried to determine the most appropriate strategy to be implemented in patients with various risk factors II. Aim of the study Trimetazidine alone versus trimetazidine plus allopurinol as a preventive of CA-AKI in patients receiving elective PCI. Hydration Plus Trimetazidine 20 mg twice a day, or 35 mg once daily, will be offered to patients before the procedure and up to 24 hours after the procedure and allopurinol 300 mg once daily for the first 5 hours before the procedure and then again the next day of the operation. Patients with left ventricular systolic dysfunction Syndrome will be hydratedized by intravenous administration of normal saline at a rate of 0. 5 ml/ kg body weight per hour. Modification of Diet in Renal Disease Study and Chronic Kidney Disease Epidemiology According to the stage set by the U. S. National Kidney Foundation and determined by the eGFR value as normal kidney function, kidney damage will be estimated, with a GFR value of 60-89 ml/minute and mild kidney injury. The quantitative results were calculated using the G*Poweru00b1 software version 3. 1. 9. 2 Statistical Analysis The continuous variables will be compared between the three groups using the 2-way Anova, and will be reported as mean u00b1 standard deviation.
Source link: https://clinicaltrials.gov/ct2/show/NCT05540184
Cirrhosis is a leading cause of global health problems worldwide. In 20% of hospitalized patients with cirrhosis, acute kidney injury occurs. Acute kidney injury is a relatively new measure of renal impairment that takes into account the fluid changes in serum creatinine. HRS-AKI is an acute disease that occurs in patients with ascites, mainly refractory ascites. Although HRS-AKI contains the classic hepatorenal syndrome type 1 and has an ominous prognosis if left untreated, HRS-AKI also includes milder forms of renal disease. Increased pressure in the portal vein, also known as portal hypertension, is one of the main pathophysiological factors contributing to cirrhosis' specifics. Transjugular intrahepatic shunt is an interventional radiological procedure that relieves the pressure in the portal vein by cutting a short-cut between the portal vein and the hepatic vein, the vein that leads the blood from the liver to the heart. Traditional HRS type 1 can, on the other hand, can be traced to liver dysfunction and cardiac alterations, which contraindicate TIPS placement. Traditional HRS-AKI includes not only classic HRS type 1, but also more severe forms of the disease, so it is likely that TIPS placement may have a role in this condition. Patients with cirrhosis and HRS-AKI who meet the inclusion criteria and do not have any exclusion criteria will be randomized to a minimum of care or tipping.
Source link: https://clinicaltrials.gov/ct2/show/NCT05346393
Despite advances in supportive care, acute renal failure remains high. The failure of these agents in human ARF may be due to late enrollment in the trial; safe therapy will likely require earlier detection. During ARF testing, urinary proteins were determined. The aim of this scientific study is to find new biomarkers of renal injury, progression, or recovery by analyzing urine proteins. Patients with ARF, patients at high risk of ARF, patients with volume depletion, patients with urinary tract infection, patients with chronic kidney disease, and healthy controls will be included in this survey. If ARF does develop, those patients at a high risk of ARF will be followed prospectively and will undergo additional testing if ARF exists. After creatinine levels return to normal, patients will also be monitored. Protein and/or microRNA biomarkers that are unique to ARF patients may be identified, but not found in healthy subjects or patients with volume depletion.
Source link: https://clinicaltrials.gov/ct2/show/NCT00026702
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