ClinicalTrials.gg
RecruitingNCT05817539EarlyDryUpdated Nov 3, 2026

Early Deresuscitation Strategy Driven by Tissue Perfusion in Renal Replacement Therapy in Patients With Acute Renal Failure

An interventional study of Fluid balance negativation and Body weight Stabilization in Acute Kidney Injury and Fluid Overload, sponsored by Hospices Civils de Lyon. Recruiting at 14 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-03.

Sponsored by Hospices Civils de Lyon · Not applicable, Interventional, and Other

From the registry’s dates

  • Started Dec 2023; still recruiting 2 years 10 months later.
Updated Nov 3, 2026Site recruiting status changedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
250
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

In Intensive Care Unit (ICU) patients with acute kidney injury (AKI) and treated with renal replacement therapy (RRT) often present a fluid overload which is associated with morbidity (mechanical ventilation duration increase, kidney recovery decrease) and mortality.

Patients' prognostic could be improved by correcting the fluid overload with net ultrafiltration (UFnet) however it may lead to harmful iatrogenic hypovolemia responsible of deleterious ischemic lesions.

In usual practice, UF net prescription are variable and there are different international recommendations. Some observational studies suggest that using a UFnet between 1 et 1.75 mL/kg/h in fluid overloaded patient decrease mortality.

Fluid overload increases morbidity and mortality, particularly in RRT. Studies without RRT argue for an efficacy of management by decreasing the fluid overload .Cohort studies suggest to use a moderate UFnet instead of a low UFnet. Some data from studies on early versus late RRT that relate the fluid balance or correct the fluid overload during the early strategy argue for a beneficial effect of an early deresuscitation strategy

Consequently, the impact of a moderate UFnet (to decrease the fluid overload) compared to a low UFnet (to stabilize the fluid overload) in a randomized interventional study could be assessed.

The study hypothesis is that :

an early fluid overload deresuscitation protocol with a high UFnet (2 ml/kg/h) targeting both the negativation of cumulated fluid balance to reach a dry weight and the maintenance of tissue perfusion.

Compared to

fluid overload deresuscitation protocol with a low UFnet (between 0 and 1 ml/kg/h) to reach a stabilization of cumulated fluid balance without monitoring the tissue perfusion.

could improve overall, renal, hemodynamic and respiratory prognosis in fluid overloaded patients with renal replacement therapy in ICU

02

Conditions studied

  • Acute Kidney Injury
  • Fluid Overload

Keywords

  • Renal Replacement Therapy (RRT)
  • Ultrafiltration
  • Deresuscitation
  • Fluid balance
  • Fluid overload
  • Tissue perfusion
03

In context

Acute Kidney Injury

1,691 studies on the registry are indexed under Acute Kidney Injury; 395 are open to participants now.

This study's planned enrollment of 250 is above the median of 100 across 817 interventional studies indexed under Acute Kidney Injury.

Browse Acute Kidney Injury studies →

Lead sponsor

Hospices Civils de Lyon is the lead sponsor of 1,866 studies on the registry; 448 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Acute kidney injury treated by continuous renal replacement therapy in ICU less than 7 days,
  2. At least 1 organ failure during ICU in addition to AKI (mechanical ventilation or oxygen therapy or vascular filling > 1000ml or vasopressor exposure > 12 hours),
  3. Weight loss of less than 3% since starting a net UF or Cumulative UF net less than 2000ml before inclusion,
  4. Norepinephrine \< 0,5 µg/kg/min,
  5. Absence of hypoperfusion signs defined by the presence of at least 2 out of 4 criteria:

    • TRC > 3s at the finger
    • Marbrure score > 2
    • Lactate > 2 mmol/L
    • ScVO2\< 60%,
  6. Fluid overload defined as follows :

    • fluid overload > 5% of base weight (based on cumulative fluid balance or a weight gain) and/or
    • Obvious oedema of the lumbar region or flanks (oedema > 1cm bucket depth).

Exclusion criteria

Exclusion Criteria:

  1. Chronic renal failure hemodialyzed before admission to the ICU,
  2. Mechanical circulatory support (ECMO, LVAD),
  3. Pregnant, child -bearing age or lactating women,
  4. Stroke based on the combination of central neurological symptoms (aphasia, hemiplegia, hemiparesis) associated with compatible brain imaging, less than 30 days,
  5. Intestinal ischemia less than 7 days documented non-operated,
  6. Interventional study participation or exclusion period on going,that may interfere with the present study
  7. Guardianship, curatorship or safeguard of justice,
  8. Absence of signature of free and by the patient and/or relative,
  9. Patients not affiliated to a social security scheme or beneficiaries of a similar scheme
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
250 participants (estimated)

Study arms

  • Experimental
    Corrective strategy

    In the experimental group, all patients will have a UFnet settled (2 ml/kg/h ) in order to reach the patient baseline body weight.

    Procedure: Fluid balance negativation

  • Other
    Stabilizing strategy

    In the control group, all patients will have a UFnet 2 ml settled (0 to 1 ml/kg/h) in order to stabilize the patient body weight.

    Procedure: Body weight Stabilization

Interventions

  • ProcedureFluid balance negativation

    During the RRT, UFnet will be settled on 2ml/kg/h and adapted to hemodynamic tolerance and tissue perfusion . When the patient's baseline body weight is reached the UF net will be settled to maintain it. In case of failure of the fluid balance negativation after 24h, UFnet will be settled on 3ml/kg/h. Then when the baseline body weight is reached UFnet will be settled on 0.5 et 1ml/kg/h or if necessary adapted to 1,5ml/kg/h to maintain it In case of hemodynamic intolerance (NADN \> 0,5 µg/kg/min) or tissue hypoperfusion, UF net will be stopped during 6 hours and restarted if NADN \< 0,5 µg/kg/min and without tissue hypoperfusion.

  • ProcedureBody weight Stabilization

    During the RRT, UFnet will be settled between 0 et 1 ml/kg/h and adapted in case of weight stabilization failure or hemodynamic intolerance. In case of weight stabilisation failure ( variation \>3% after 24h), the UF net can be increased to 1,5 ml/kg/h, as long as high intakes require UFnette at 1.5mL/kg/h to stabilize water balance, with daily reassessment. In case of hemodynamic intolerance (NADN \> 0,5 µg/kg/min), UF net will be stopped during 6 hours and restarted if NADN \< 0,5 µg/kg/min.

06

What researchers measure

Primary outcomes

  1. Number of organ replacement free-days

    Number of organ replacement free-days, i.e, number of renal replacement therapy-free days, number of vasopressor-free days, number of ventilator-free day. Number of days between 2 same type organ replacement interruption is not counted. In case of death before 30 days, number of days is censored to 0.

    Time frame: Day 30

Secondary outcomes

  1. Mortality decrease

    Number of deaths

    Time frame: 30 days

  2. Number of renal replacement therapy-free days increase

    Number of renal replacement therapy-free days

    Time frame: Day 30

  3. Number of ventilator-free day increase

    Number of ventilator-free day

    Time frame: Day 30

  4. Number of vasopressor-free day increase

    Number of vasopressor-free day

    Time frame: Day 30

  5. Duration of intensive care unit stay

    Number of days in ICU

    Time frame: Up to Day 30

  6. SOFA score evolution

    SOFA score : Sepsis-related Organ Failure Assessment, min : 0 max : 24 (worse)

    Time frame: From Day 0 up to Day 5

  7. Incidence of arrhythmias and cardiac conduction disorders in both group

    Number of arrhythmias and cardiac conduction disorders occurrence on ECG

    Time frame: From Day 0 up to Day 5

  8. Incidence of intestinal ischemia in both group

    Number of intestinal ischemia on CT scan or endoscopy

    Time frame: From Day 0 to Day 30

  9. Incidence of strokes

    Number of ischemic strokes occurrence on imagery

    Time frame: From Day 0 to Day 30

  10. Incidence of delirium

    Presence of delirium assessed with the CAM ICU scale : positive or negative score. A positive score means presence of delirium

    Time frame: Between Day 0 and Day 5

  11. Renal recovery assessment

    Renal recovery is defined according to MAKE 30 scale : * Survival * Absence of renal replacement therapy * Day 30 creatinine level \< baseline creatinine x 200 %

    Time frame: Day 30

07

Study locations

13 of 14 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Dec 2023 (actual). Primary completion is estimated for Jan 2028, 49 months after the start.

Of 249 non-industry interventional studies with no phase under Acute Kidney Injury, half reached primary completion within 27 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 44. This study's planned 49 months is above that.

Counting every sponsor, half of 267 studies reached it within 26 months; a quarter within 12 and three quarters within 44.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 5, 2023
First posted
Apr 18, 2023
StartActual
Dec 15, 2023
Primary completionEst.
Jan 15, 2028
CompletionEst.
Jan 15, 2028
Last update
Nov 3, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Sites
7 sites changed recruiting status (7 now recruiting)
Show 7 sites
  • Centre Hospitalier d'Ajaccio · Ajaccio, FranceNot yet recruiting→Recruiting
  • CHU Amiens-Picardie · Amiens, FranceNot yet recruiting→Recruiting
  • GHP Saint Joseph Marie Lannelongue · Le Plessis-Robinson, FranceNot yet recruiting→Recruiting
  • CHU Lille - Hôpital Roger Salengro · Lille, FranceNot yet recruiting→Recruiting
  • Hôpital de la Croix Rousse · Lyon, FranceNot yet recruiting→Recruiting
  • Hôpital Edouard Herriot · Lyon, FranceNot yet recruiting→Recruiting
  • Hôpitaux de Bradois - CHRU Nancy · Vandœuvre-lès-Nancy, FranceNot yet recruiting→Recruiting
Nov 3, 2026
Site contacts
Changed at 2 sites. See the sites
Show 2 sites
  • Hôpital Edouard Herriot, Groupement Hospitalier Centre · Lyon, FranceContact f•••@chu-lyon.fr · •••6942→c•••@chu-lyon.fr · •••0164Contact person changed (no phone or email listed)
  • Hôpitaux de Bradois - CHRU Nancy · Vandœuvre-lès-Nancy, FranceContact P•••@chru-nancy.fr · •••7995→P•••@chru-nancy.fr · •••7995Contact person changed (no phone or email listed)
Nov 3, 2026
Show all 1 update
  1. Nov 3, 2026
    7 sites changed recruiting status (7 now recruiting)
    Show 7 sites
    • Centre Hospitalier d'Ajaccio · Ajaccio, FranceNot yet recruiting→Recruiting
    • CHU Amiens-Picardie · Amiens, FranceNot yet recruiting→Recruiting
    • GHP Saint Joseph Marie Lannelongue · Le Plessis-Robinson, FranceNot yet recruiting→Recruiting
    • CHU Lille - Hôpital Roger Salengro · Lille, FranceNot yet recruiting→Recruiting
    • Hôpital de la Croix Rousse · Lyon, FranceNot yet recruiting→Recruiting
    • Hôpital Edouard Herriot · Lyon, FranceNot yet recruiting→Recruiting
    • Hôpitaux de Bradois - CHRU Nancy · Vandœuvre-lès-Nancy, FranceNot yet recruiting→Recruiting
    Site contacts Changed at 2 sites. See the sites
    Show 2 sites
    • Hôpital Edouard Herriot, Groupement Hospitalier Centre · Lyon, FranceContact f•••@chu-lyon.fr · •••6942→c•••@chu-lyon.fr · •••0164Contact person changed (no phone or email listed)
    • Hôpitaux de Bradois - CHRU Nancy · Vandœuvre-lès-Nancy, FranceContact P•••@chru-nancy.fr · •••7995→P•••@chru-nancy.fr · •••7995Contact person changed (no phone or email listed)
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT05817539
Responsible party
Sponsor
First posted
Apr 18, 2023
Start date
Dec 15, 2023
Primary completion
Jan 15, 2028 (estimated)
Completion
Jan 15, 2028 (estimated)
Last update
Nov 3, 2026

Study contacts

Matthias JACQUET LAGREZE, MD PhD
Contact
Matthias.jacquet-lagreze@chu-lyon.fr
04 72 35 79 41 ext. +33
Julia CANTERINI, project manager
Contact
Julia.canterini@chu-lyon.fr
04 27 85 66 28 ext. +33

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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