CClinicalTrials.gg
Status unknownNCT03489759Vitabrane EUpdated Apr 4, 2019

The Effect of Vitamin E-coated Polysulfone Membrane on Oxidative Stress, Inflammation and Monocytes in Critically Ill Patients in CRRT

An interventional study of ViE15-A and REXEED-15A in Renal Failure and Renal Insufficiency, Acute, sponsored by St. Bortolo Hospital. Status unknown at 1 site in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-04-04.

Sponsored by St. Bortolo Hospital · Not applicable, Interventional, and Health services research

The sponsor has not verified this record recently (last verified Apr 2019), so the status shown — last known as Recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The study evaluate the effect of a membrane in polysulfone covered with vitamin E (ViE15-A, ASAHI Kasey, Tokyo, Japan) versus non-vitamin E polysulfone membrane (REXEED-15A, ASAHI Kasey, Tokyo, Japan) in critically ill patients admitted to intensive care undergoing continuous extracorporeal dialysis (CRRT).

The current randomized study is designed to assess the effect on the levels of oxidative stress, pro and anti-inflammatory cytokines and the mode and amount of death of monocytic cell lines using ViE 15-A in comparison withe REXEED-15A.

The investigators hypothezise that the ViE15-A versus REXEED-15A will have different effect on the levels of oxidative stress, pro and anti-inflammatory cytokines and the mode and amount of death of monocytic cell lines.

Read the detailed description

The study evaluate the effect of a membrane in polysulfone covered with vitamin E (ViE15-A, ASAHI Kasey, Tokyo, Japan) on the levels of oxidative stress, pro and anti-inflammatory cytokines and the mode and amount of death of monocytic cell lines in critically ill patients admitted to intensive care undergoing continuous extracorporeal dialysis (CRRT).

This membrane will be compared with a non-vitamin E polysulfone membrane (REXEED-15A, ASAHI Kasey, Tokyo, Japan) and already intended for use in continuous renal support therapy.

The current randomized study is designed to assess the effect on the levels of oxidative stress, pro and anti-inflammatory cytokines and the mode and amount of death of monocytic cell lines using ViE 15-A in comparison withe REXEED-15A.

Precisely, will be evaluated

  1. the effect of the filter on the reduction of the plasma levels of two pro-inflammatory cytokines (IL-1β and IL-6) and of two anti-inflammatory cytokines (IL-10, IL-8);
  2. the analysis of the life modality of the monocytic cells: the patient's plasma will be used, incubated for 24 hours with U937 cells (monocyte precursor cells), necrosis cells and the percentage of apoptotic cells. The apoptotic cells will also evaluate the apoptotic pathway (evaluation of activated caspases) that led to cell death. The differences that are highlighted in the two different sampling moments become expressed Δ% with respect to the initial value Secondary outcomes will be to evaluate the clinical outcomes (haemodynamic and hematochemical parameters) in the short and long term deriving from the application of a membrane with vitamin E; for this reason, for the whole duration of the extracorporeal dialysis therapy, the same filter assigned to the patient at the time of enrollment will be used.

All the other parameters of the extracorporeal treatment that can influence the results will be standardized; in particular, the flows will be fixed according to the dialysis dose criteria and re-infusion methods according to the table in the paragraph "treatment characteristics".

02

Conditions studied

  • Renal Failure
  • Renal Insufficiency, Acute

Keywords

  • Acute Kidney Injury
  • Oxidative Stress
  • Renal Replacement Therapy
  • Vitamine E-coated Polysulfone Membrane
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age > 18 years
  • Acute Kidney Injury
  • ICU patients with clinical indication for Continuous Renal Replacement Therapy
  • Clinical decision to begin CVVH for at least 24 hours with high flux filter (defined as membranes with an ultrafiltration coefficient KUF > 25ml/Kg/h)
  • Obtain the informed consent

Exclusion criteria

Exclusion Criteria:

  • Hemodialysis patients, peritoneal dialysis patients and transplant recipient;
  • Hypothermia (T \< 36°C)
  • Regional Anticoagulation with Citrate
  • Septic Shock;
  • Neoplasm in Chemotherapy
  • Extra-Corporeal Membrane Oxygenation
  • Cardio Circulatory Arrest
  • Autoimmune disease or immunosuppressed patients;
  • Life expectancy \< 24 hr
  • Pregnancy;
  • Informed Consent refused by the patient or surrogate decision-maker
04

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    ViE15-A

    The patients were randomly allocated to two groups by using computer-generated numbers. The renal replacement therapy will be started using ViE15-A hemofilter

    Device: ViE15-A

  • Active comparator
    REXEED-15A

    TThe patients were randomly allocated to two groups by using computer-generated numbers. The renal replacement therapy will be started using REXEED-15A

    Device: REXEED-15A

Interventions

  • DeviceViE15-A

    The type of dialytic treatment that will be used during the study will be continuous venous hemofiltration (CVVH-Continuous veno-venous hemofiltration). The filter will be ViE15-A.

  • DeviceREXEED-15A

    The type of dialytic treatment that will be used during the study will be continuous venous hemofiltration (CVVH-Continuous veno-venous hemofiltration). The filter will be REXEED-15A.

05

What researchers measure

Primary outcomes

  1. Copper/Zinc

    In vivo comparison of ROS concentrations in two groups

    Time frame: change from 24 to 72 hours

  2. Superoxide Dismutas

    In vivo comparison of ROS concentrations in two groups

    Time frame: change from 24 to 72 hours

  3. Endogenous peroxidase activity

    In vivo comparison of ROS concentrations in two groups

    Time frame: change from 24 to 72 hours

  4. Nitric Oxide

    In vivo comparison of ROS concentrations in two groups

    Time frame: change from 24 to 72 hours

  5. Viability

    Ex vivo comparison of relative decrease of monocytes cell line incubated in plasma

    Time frame: change from 24 to 72 hours

  6. Apoptosis

    Ex vivo comparison of relative decrease of monocytes cell line incubated in plasma

    Time frame: change from 24 to 72 hours

  7. Necrosis

    Ex vivo comparison of relative decrease of monocytes cell line incubated in plasma

    Time frame: change from 24 to 72 hours

  8. Interleukine-6

    In vivo comparison of relative reductions of inflammatory cytokines concentrations in two groups

    Time frame: change from 24 to 72 hours

  9. Interleukine -10

    In vivo comparison of relative reductions of inflammatory cytokines concentrations in two groups

    Time frame: change from 24 to 72 hours

  10. Interleukine-18

    In vivo comparison of relative reductions of inflammatory cytokines concentrations in two groups

    Time frame: change from 24 to 72 hours

Secondary outcomes

  1. Comparison of CRRT-free days from enrollment to ICU discharge in two groups

    The assessment of the effect of both hemofilters on short term clinical renal outcomes

    Time frame: 7 days

  2. Comparison of mechanical Ventilation-free days from enrollment to ICU discharge in two groups

    The assessment of the effect of both hemofilters on short term clinical renal outcomes

    Time frame: 7 days

  3. Comparison of vasopressor drugs-free days in two groups

    The assessment of the effect of both hemofilters on short term clinical renal outcomes

    Time frame: 7 days

  4. Comparison of ICU length of stay in two groups

    The assessment of the effect of both hemofilters on short term clinical renal outcomes

    Time frame: 7 days

  5. Comparison of renal recovery in two groups

    The assessment of the effect of both hemofilters on short term clinical renal outcomes

    Time frame: 7 days

  6. Comparison of CRRT-free days from enrollment to hospital discharge in two groups

    The assessment of the effect of both hemofiltes on long term clinical renal outcomes

    Time frame: 90 days

  7. Comparison of need of (Intermittent Hemodialysis) IHD at hospital discarge in patients treated with vitamine E-coated membrane and non-vitamin E-coated membrane

    The assessment of the effect of both hemofiltes on long term clinical renal outcomes

    Time frame: 90 days

  8. Comparison of renal recovery at hospital discharge in two groups

    The assessment of the effect of both hemofiltes on long term clinical renal outcomes

    Time frame: 90 days

06

Study locations

1 of 1 sites recruiting
07

Registry details

Key details

Study ID
NCT03489759
Lead sponsor
St. Bortolo Hospital
Responsible party
Silvia De Rosa (Medical Doctor, St. Bortolo Hospital) — Principal investigator
First posted
Apr 5, 2018
Start date
Mar 13, 2018
Primary completion
Sep 13, 2018
Completion
Dec 13, 2019 (estimated)
Last update
Apr 4, 2019

Study contacts

Silvia De Rosa, MD
Contact
derosa.silvia@ymail.com
+393933098583
Claudio Ronco, MD
study director · Department of Nephrology, Dialysis and Transplantation

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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