Evaluating fluid tolerance in patients with acute kidney injury using ultrasound

UltraSound Evaluation of Fluid tOleRanCE for Acute Kidney Injury: A Pilot Randomized Controlled Trial

This study is testing if using ultrasound can help doctors figure out how much fluid patients with acute kidney injury can safely receive to avoid complications.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Centre hospitalier de l'Université de Montréal (CHUM) (Academic / other)
• Locations: 1 site (Montreal, Quebec)
• Trial ID: NCT06411080 on ClinicalTrials.gov

What this trial studies

This pilot randomized controlled trial aims to assess the feasibility of using point-of-care ultrasound (POCUS) to evaluate fluid tolerance in adults with acute kidney injury (AKI). The study will compare management strategies based on ultrasound findings to determine if this approach can improve clinical decision-making and reduce complications associated with fluid therapy. Participants will be adults admitted to the hospital with AKI, and the trial will focus on those for whom fluid expansion is being considered. The goal is to identify patients at high risk for congestive complications before administering intravenous fluids.

Who should consider this trial

Good fit: Ideal candidates for this study are adults aged 18 and older who are hospitalized with acute kidney injury and for whom fluid expansion is being considered.

Not a fit: Patients admitted to the intensive care unit or those with stage 5 chronic kidney disease receiving renal replacement therapy are unlikely to benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to more precise fluid management in patients with acute kidney injury, potentially reducing complications and improving outcomes.

How similar studies have performed: While the use of ultrasound in fluid management is gaining interest, this specific approach in the context of acute kidney injury is relatively novel and has not been extensively tested.

Eligibility criteria

Inclusion Criteria:

1. Adults ≥ 18 year-old
2. Admitted to the hospital
3. Acute kidney injury defined by the KDIGO criteria\[48\]
4. Fluid expansion is considered by attending nephrologist or already ongoing

Exclusion Criteria:

1. Admitted to the intensive care unit
2. Known stage 5 chronic kidney disease according to the KDIGO classification receiving renal replacement therapy or not.
3. Renal replacement therapy for AKI has been initiated or is planned within 24 hours

Where this trial is running

Montreal, Quebec

• Centre Hospitalier de l'Université de Montréal — Montreal, Quebec, Canada (Recruiting)

Study contacts

• Principal investigator: William Beaubien-Souligny, MD PhD — Centre Hospitalier d'Université de Montréal
• Study coordinator: William Beaubien-Souligny, MD PhD

Conditions Acute Kidney Injury; point-of-care ultrasound; VExUS; Lung ultrasound; Fluid therapy; acute kidney injury