Preventing low blood pressure during ICU dialysis using a Hypotension Prediction Index
Official title: Hypotension Prediction Index Guided Prevention of Intradialytic Hypotension During Intermittent Renal Replacement Therapy in Intensive Care Units
Run by Chulalongkorn University · NCT07179705 · Data updated 2026-11-12
This trial tests whether using a Hypotension Prediction Index to guide care during prolonged dialysis can reduce episodes of low blood pressure in critically ill adults who have an arterial line.
Quick facts
| Study type | Interventional |
|---|---|
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 46 (estimated) |
| Sponsor | Chulalongkorn University Academic / other |
| Locations | 1 site (Bangkok) |
| Status | Recruiting |
| Started | October 10, 2025 |
| Main results expected | December 31, 2026 |
| Study ends | December 31, 2026 |
| Registry record updated | May 7, 2026 |
| Trial ID | NCT07179705 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Ideal candidates are adults in the medical ICU with AKI or ESKD who are scheduled for PIRRT and already have an indwelling arterial catheter for continuous monitoring.
✕Probably not a fit
Patients with severe right heart dysfunction, significant valvular disease, arrhythmias, on mechanical circulatory support, without arterial access, lacking an ultrafiltration prescription, under palliative care, or expected to leave the ICU within 72 hours are unlikely to benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This single-center, randomized crossover trial enrolls critically ill adults with acute kidney injury or end-stage kidney disease who are scheduled for prolonged intermittent renal replacement therapy (PIRRT). Participants are randomized in blocks stratified by kidney status and vasopressor use to receive either management guided by the Hypotension Prediction Index (HPI) displayed on the Hemosphere monitor or standard hemodynamic monitoring. Continuous arterial waveform data are monitored in real time and clinical responses are reassessed after each intervention during PIRRT sessions. The primary question is whether HPI guidance reduces the frequency or severity of intradialytic hypotension compared with usual care.
Why it matters
Potential benefit: If successful, this approach could reduce episodes of low blood pressure during dialysis, improving dialysis tolerance and potentially lowering organ injury and vasopressor needs.
How similar studies have gone: HPI-guided management has shown promise in operating room and some critical care studies, but applying it specifically to PIRRT in ICU patients is relatively novel and not yet widely validated.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Adults \>18 years old * Diagnosed with acute kidney injury (AKI) or end-stage kidney disease (ESKD) * Admitted to medical ICU * Scheduled for PIRRT * Have an indwelling arterial catheter Exclusion Criteria: * Severe right heart dysfunction, significant valvular disease, arrhythmias, mechanical circulatory support, absence of arterial access, no UF prescription, palliative care, or expected ICU stay \<72 hours.
Where it's running
-
Division of Nephrology, Faculty of Medicine, Chulalongkorn University
Bangkok, Thailand Recruiting
Study contacts
- Study coordinator: Nattapakorn Mai-on
- Email: nattapakorn.m@gmail.com
- Phone: 66970051116
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.