Fluid balance guided by mVExUS in ICU patients on CRRT with acute kidney injury

Is this trial a fit for you?

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

What this trial studies

This randomized trial compares mVExUS-guided fluid management to standard care in critically ill adults with acute kidney injury receiving continuous renal replacement therapy. The intervention uses periodic mVExUS assessments to guide ultrafiltration fluid removal rates, adjusted by patient profile and serial lactate monitoring, over 72 hours. Fluid management decisions are linked to hemodynamic and lactate responses, with predefined strategies to pause or resume UFNET based on fluid responsiveness and clinical status. CRRT modality and dose follow KDIGO guidelines, indexed to body weight, with adjustments for obesity. The study aims to determine whether mVExUS guidance reduces cumulative fluid balance and CRRT-related complications such as intradialytic hypotension and arrhythmias.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Adults (≥ 18 years of age)
* Admitted to ICU
* Acute kidney injury by KDIGO criteria
* Initiated CRRT by at least one of the following indications for RRT initiation:
* Serum potassium ≥ 6.0 mmol/L, or
* pH ≤ 7.20 or serum bicarbonate ≤ 12 mmol/L, or
* Evidence of severe respiratory failure, based on a PaO2/FiO2 ≤ 200 and clinical perception of volume overload, or
* Persistent severe AKI (sCr remains \> 50% the value recorded at randomization) for \> 72 hours from randomization
* Participants giving informed consent

Exclusion Criteria:

* Refuse to participate
* Previous diagnosis of end-stage kidney disease (ESKD) currently on kidney replacement therapy
* Kidney transplant recipient
* Receive RRT before ICU admission within 90 days
* Structural kidney diseases which will interfere with intrarenal doppler ultrasound e.g. renal artery stenosis, autosomal dominant polycystic kidney disease
* Patients with previously known conditions that interfere with portal doppler assessment, namely liver cirrhosis, severe tricuspid regurgitation with structural heart disease or massive ascites.
* Underlying disease process with a life expectancy less than 90 days
* Pregnancy
* Severe cardiac rhythm disturbances (tachyarrhythmia, supraventricular tachycardia)
* Intra-cardiac shunts; Ventricle septal defect, patent foramen ovale, atrial septal defect
* Aortic aneurysm
* Intra-abdominal hypertension (intraabdominal pressure ≥20 mmHg)
* Expected life expectancy \<48 hours
* Receiving extracorporeal membrane oxygenation (ECMO)

Where it's running

• King Chulalongkorn Memorial Hospital
  Bangkok, Thailand Recruiting
• Vajira Hospital, Navamindradhiraj University
  Bangkok, Thailand Not yet recruiting

Study contacts

• Study coordinator: thanphisit trakarnvanich, Bachelor's Degree
• Email: thanphisit2@hotmail.com
• Phone: +66896996830

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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.