RecruitingNAINTERVENTIONAL

WISDOM UK: Low Dose-intensity Versus Standard Dose-intensity CRRT in Critically Ill Patients

If you're critically ill and your kidneys aren't working properly (called acute kidney injury), you might need a treatment called dialysis. This treatment cleans your blood by removing harmful substances and extra fluid. Doctors aren't sure about the best 'intensity' (how much cleaning) for this treatment. Too much might remove good things like vitamins, while too little might not clean enough. This study will compare the usual intensity of dialysis with a lower intensity to see if the lower dose is just as effective and safe. We hope to learn if a lower dose could help kidneys recover faster. The results will help doctors decide the best way to give this treatment in the future.

At a glance

Status

Recruiting

Phase

Sponsor

Guy's and St Thomas' NHS Foundation Trust

Enrolment target

Start

15 Feb 2025

Estimated completion

30 Mar 2027

Acute Kidney Injury (Nontraumatic)Dialysis; Complications

What is this study about?

When someone is seriously unwell in intensive care, their kidneys can sometimes stop working properly. This is called acute kidney injury. When this happens, a special blood cleaning treatment called dialysis is often needed. Dialysis works by taking blood out of the body, cleaning it in a machine, and then returning it. This removes harmful waste products and extra fluid that the kidneys would normally get rid of.

At the moment, doctors aren't completely sure what the 'right' amount of cleaning is for dialysis. We call this the 'intensity' of the treatment. A higher intensity cleans more, but it might also remove important things your body needs, like vitamins and nutrients. On the other hand, if the cleaning isn't intense enough, it might not remove enough of the harmful substances. Some early information suggests that a lower intensity might be just as good and could even help kidneys get better faster, but we need more proof.

This study aims to find out if a lower intensity of this dialysis treatment is as effective and safe as the usual intensity. We hope this research will help doctors across the UK decide on the best way to give dialysis to patients with acute kidney injury, making sure they get the most effective and safest care possible. The initial results will help us plan a bigger study to gather more information.

Key takeaways

Looks at kidney cleaning treatment (dialysis) for acute kidney injury.
Compares usual vs. lower intensity of treatment.
Aims to find the safest and most effective dose.
You'll be randomly assigned to one treatment group.
All other medical care remains unchanged.

Who may be eligible?

You might be able to take part in this study if you are 18 years old or older and weigh at least 55 kilograms (about 8 stone 9 pounds). This study is for people who are in intensive care and are either about to start this kidney cleaning treatment (dialysis) or have started it within the last 24 hours because their kidneys have suddenly stopped working well.

We would also expect you to receive this treatment for at least two days. The study is particularly looking for people who we believe have a good chance of getting better.

However, you cannot take part if you have a specific reason to need a very high-intensity dialysis treatment, or if you already have long-term kidney failure and regularly receive dialysis. Also, if you've already had this specific treatment for kidney injury during your current hospital stay, or if there's any reason you wouldn't be able to follow the study's plan, you wouldn't be able to join.

Quick self-check

Are you 18 years old or older?
Do you weigh at least 55 kg (about 8 stone 9 pounds)?
Are you in intensive care due to a sudden kidney problem and either starting or just started dialysis?
Are your doctors hopeful you will recover?
Have you NOT had this kidney treatment during this hospital stay already?
Do you NOT have long-term kidney failure needing regular dialysis?

This is a guide only — the research team will confirm whether you can take part.

What does participation involve?

If you decide to take part, you will be randomly assigned to receive either the usual intensity of the kidney cleaning treatment (dialysis) or a slightly lower intensity. This is done by chance, like flipping a coin, so neither you nor your doctors can choose which group you are in. It's important to remember that all other aspects of your medical care will remain exactly the same as they would normally be. There will be no changes to your other treatments or medications. The study will continue for as long as you need the kidney cleaning treatment, and your doctors will monitor your progress closely as part of your standard care.

Potential risks and benefits

Taking part in this study means you'll receive a specific level of kidney cleaning treatment. While there's a small chance a lower intensity might not be as effective for some, previous information suggests it could be just as good and potentially help your kidneys recover sooner. Your doctors will be closely monitoring you throughout. You are free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (1)

Guy's & St Thomas' Hospital
London, United Kingdom· Recruiting

Common questions

What is 'acute kidney injury'?

It means your kidneys have suddenly stopped working properly, often when you're already very unwell.

What is 'dialysis'?

It's a medical treatment that cleans your blood and removes extra fluid when your kidneys can't do it themselves.

What does 'intensity' mean in this study?

It refers to how much blood cleaning is done during the dialysis treatment.

Will I know which treatment I'm receiving?

No, you will be randomly assigned to either the usual or lower intensity, like drawing lots.

Are there any extra appointments if I join?

No, your medical care and monitoring will be the same as usual.

How to find out more

Marlies Ostermann, PhD

m.ostermann@nhs.net +442071883036 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.