Proenkephalin A and Kidney Replacement Therapy

University of Giessen

Status: Terminated

Conditions: Acute Kidney Injury

Treatments: Other: None planned

Study type: Observational

Funder types: Other

Identifiers

NCT04879706

AZ 37/21

Details and patient eligibility

About

Acute kidney injury (AKI) is a common problem encountered in the intensive care unit (ICU), estimated to occur in up to 60% of all critically ill patients, depending on the definition. Recent large randomized clinical trials in critical care nephrology have focused on the optimal timing of initiation of acute kidney replacement therapy (KRT). However, less is known about the ideal circumstances in which KRT may be successfully discontinued.

The novel serum-biomarker proenkephalin A 119-159 (penkid) has been found to be strongly negatively correlated with measured GFR. Whether penkid may have a role in initiation and discontinuation of KRT remains unknown.

Full description

Acute kidney injury (AKI) is a common problem encountered in the intensive care unit (ICU), estimated to occur in up to 60% of all critically ill patients, depending on the definition. Recent large randomized clinical trials in critical care nephrology have focused on the optimal timing of initiation of acute kidney replacement therapy (KRT). However, less is known about the ideal circumstances in which KRT may be successfully discontinued. KRT is a complex and expensive therapy, with complications including catheter-associated infections, hemorrhage, hemodynamic instability, and potential delayed renal recovery.

The novel serum-biomarker proenkephalin A 119-159 (penkid) is a stable fragment derived from the precursor enkephalins, which are known as small endogenous opioid peptides and are produced throughout the human body, including the kidneys. Plasma concentrations of penkid have been found to be strongly negatively correlated with measured glomerular filtration rate. Whether penkid may have a role in initiation and discontinuation of KRT remains unknown.

Enrollment: 6 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients ≥18 years of age with AKI requiring KRT

Exclusion criteria

• Chronic kidney disease with estimated glomerular filtration rate <30 mL/min/1.73 m2
• Non-end stage renal disease with extracorporeal ultrafiltration due to diuretic- resistant fluid overload
• Decision to limit therapeutic interventions
• History of solid-organ transplants
• Pregnancy

Trial design

6 participants in 1 patient group

AKI necessitating KRT

Description:

Patients with AKI necessitating KRT

Treatment:

Other: None planned