Low-intensity versus standard-intensity continuous dialysis for critically ill adults with acute kidney injury
WISDOM UK: Low Dose-intensity Versus Standard Dose-intensity Continuous Renal Replacement Therapy in Critically Ill Patients: a Randomized Trial
NA · Guy's and St Thomas' NHS Foundation Trust · NCT07447791
This will try giving lower-intensity continuous dialysis instead of the usual intensity to adults in intensive care with acute kidney injury to see if kidneys recover just as well with fewer side effects.
Quick facts
| Phase | NA |
|---|---|
| Study type | Interventional |
| Enrollment | 20 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Guy's and St Thomas' NHS Foundation Trust (other) |
| Locations | 1 site (London, Greater London) |
| Trial ID | NCT07447791 on ClinicalTrials.gov |
What this trial studies
Adult ICU patients starting continuous renal replacement therapy (CRRT) are randomly assigned to receive either a lower prescribed dose of CRRT or the usual dose (around 25 ml/kg/hr). Eligible patients are ≥18 years, weigh ≥55 kg, and are expected to need CRRT for at least 48 hours, while those on maintenance dialysis or needing sustained higher-intensity CRRT are excluded. The intervention changes the CRRT dose delivered through the same catheter and machines, and the trial tracks kidney recovery, safety events, and survival during the ICU stay. The procedure is conducted at Guy's & St Thomas' Hospital in London with follow-up through the hospitalization to capture clinical outcomes.
Who should consider this trial
Good fit: Adults with acute kidney injury in the ICU who are starting or within 24 hours of starting CRRT, weigh at least 55 kg, and are expected to need CRRT for 48 hours or more are ideal candidates.
Not a fit: Patients already on long-term dialysis, those who previously received RRT during the current hospital stay, or those who require sustained higher-intensity CRRT are unlikely to benefit from this comparison.
Why it matters
Potential benefit: If successful, lower-intensity CRRT could allow faster kidney recovery and reduce loss of nutrients and medications while remaining as safe as standard dosing.
How similar studies have performed: Large observational databases have suggested lower CRRT doses may be safe and could speed kidney recovery, but randomized confirmation is limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * age ≥ 18 years * patient weight ≥ 55 kg * plan to start CRRT or within 24 hours of having started CRRT for AKI * expected to survive and receive CRRT for a duration of ≥ 48 hours Exclusion Criteria: * indication for sustained higher dose-intensity CRRT * end-stage kidney disease receiving maintenance dialysis * previous receipt of RRT for AKI during the current hospitalization * inability to comply with the requirements of the study protocol
Where this trial is running
London, Greater London
- Guy's & St Thomas' Hospital — London, Greater London, United Kingdom (RECRUITING)
Study contacts
- Study coordinator: Marlies Ostermann, PhD
- Email: m.ostermann@nhs.net
- Phone: +442071883036
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions: Acute Kidney Injury, Dialysis, Complications, renal replacement therapy, dose, acute kidney injury