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Clinical trial Recruiting at 4 sites Phase 3 Interventional Ages 18 and up

Angiotensin II to reduce kidney injury after heart surgery

Official title: A Prospective Angiotensin II Versus Noradrenaline Trial for Hypotension Management to Reduce Cardiac-surgery Associated Acute Kidney Injury (PAN-AKI)

Run by Universität Münster · NCT06615102 · Data updated 2026-11-12

This trial tests whether angiotensin II, used as the primary blood-pressure medicine instead of norepinephrine after cardiac surgery with cardiopulmonary bypass, can lower the chance of moderate or severe acute kidney injury in adults at higher risk.

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Quick facts

PhasePhase 3
Study typeInterventional
Ages18 Years and up
SexAll
Enrollment1022 (estimated)
SponsorUniversität Münster
Academic / other
Locations4 sites (Berlin and 3 other locations)
StatusRecruiting
StartedMarch 31, 2025
Main results expectedJanuary 2027
Study endsApril 2027
Registry record updatedJuly 18, 2025
Trial IDNCT06615102 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Adults (≥18) having cardiac surgery with cardiopulmonary bypass (CABG, valve, or combined) who score ≥1.5 on the trial's AKI risk scale and can give written informed consent are ideal candidates.

Probably not a fit

Patients undergoing major aortic or transplant procedures, those already on vasopressors before surgery, dialysis-dependent patients, recent AKI, or with very low eGFR or severe pulmonary hypertension are unlikely to benefit or be eligible.

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a phase 3, randomized, controlled trial comparing angiotensin II versus norepinephrine as the first-line vasopressor in adults undergoing cardiac surgery with cardiopulmonary bypass who are at elevated risk for acute kidney injury. The main outcome is the occurrence of moderate or severe AKI defined by KDIGO creatinine and urine-output criteria, with secondary outcomes including need for renal replacement therapy, mortality, and length of stay. Patients with typical cardiac procedures (CABG, valve, or combined) who meet a predefined AKI risk score and provide consent are eligible, while those with major aortic/transplant surgery, preoperative vasopressor use, dialysis dependence, recent AKI, or very low eGFR are excluded. The trial is conducted at multiple German academic centers and collects perioperative hemodynamic and renal function data to compare renal outcomes between the two vasopressor strategies.

Why it matters

Potential benefit: If successful, using angiotensin II as the primary vasopressor could reduce rates of moderate or severe AKI after cardiac surgery, potentially lowering the need for dialysis, complications, and hospital stays.

How similar studies have gone: Previous surgical and shock-patient trials have shown angiotensin II can raise blood pressure and suggest possible renal benefits, but there is no definitive human evidence yet that it prevents moderate or severe cardiac-surgery associated AKI.

Who can join: the full rules

Show full inclusion / exclusion criteria 
Inclusion Criteria:

1. Cardiac surgery using cardiopulmonary bypass including coronary artery bypass grafting (CABG) surgery, valve surgery, or combined CABG/valve surgery
2. Elevated risk of AKI as predicted by a score ≥ 1.5 on the following scale:

   1. hemoglobin \< 130g/l = 2
   2. creatinine \> 1.1 mg/dl = 2
   3. age \> 70 years =1.5
   4. New York Heart Association Classification (NYHA) 4 =1.5
   5. Body Mass Index (BMI) \> 30 =1.5
3. Adult ≥ 18 years
4. Written informed consent

Exclusion Criteria:

1. Major aortic surgery (aortic arch replacement), transplant surgery, pulmonary thrombendarterectomy, ventricular assist device placement
2. Already receiving inotropic/vasopressor support before surgery
3. Dialysis dependent
4. Pre-existing AKI within the last 30 days
5. Pre-existing chronic kidney injury with an eGFR\<20 ml/min/1.73m2
6. Pre-existing significant hypertension (persistent SBP \> 180mmHg)
7. Significant pulmonary hypertension (ePSAP \> 70mmHg, mPAP \> 40mmHg) with right ventricular systolic dysfunction (graded more severe than mild)
8. Hypersensitivity to the active substance or to any of the excipients
9. Pregnancy (a negative pregnancy test for women of childbearing age) or breastfeeding women
10. Persons with any kind of dependency on the investigator or employed by the sponsor/investigator
11. Participation in another interventional trial within the last three months that investigates kidney function

Where it's running

  • Deutsches Herzzentrum der Charité
    Berlin, Germany     Recruiting
  • University Hospital Bonn
    Bonn, Germany     Recruiting
  • University Medical Center Mainz
    Mainz, Germany     Recruiting
  • University Hospital Münster
    Münster, Germany     Recruiting

Study contacts

  • Principal investigator: Alexander Zarbock, MD — University Hospital Muenster, Dept. of Anesthesiology, Intensive Care Medicine and Pain Therapy
  • Study coordinator: Alexander Zarbock, MD
  • Email: PAN-AKI@ukmuenster.de
  • Phone: +49-251-8347252

Similar studies

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How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
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Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.