Clinical trial • Nephrology | Cardiology

Angiotensin II for Acute kidney injury | Cardiac surgery-associated acute kidney injury

Clinical trial of Angiotensin II for Acute kidney injury | Cardiac surgery-associated acute kidney injury.

Overview

Trial Therapeutic Area
Nephrology | Cardiology
Trial Disease
Acute kidney injury | Cardiac surgery-associated acute kidney injury
Drug Modality
Peptide/protein/enzyme | Small molecule

Key dates

Initial CTIS Submission Date
03-12-2024
First CTIS Authorization Date
06-02-2025

Trial design

Randomised, norepinephrine (norepinephrine; noradrenaline tartrate) — infusion bag containing norepinephrine 0.1 mg/ml (intravenous perfusion). reported maximums in dataset: max daily dose amount 4.3 (mg/kg), max total dose amount 13 (mg/kg).-controlled, adaptive trial across 15 sites in Germany.

Randomised
Yes
Comparator
Norepinephrine (NOREPINEPHRINE; noradrenaline tartrate) — infusion bag containing norepinephrine 0.1 mg/ml (intravenous perfusion). Reported maximums in dataset: max daily dose amount 4.3 (mg/kg), max total dose amount 13 (mg/kg).
Adaptive
True, the design includes an interim analysis with a planned sample of approximately 1022 patients and the possibility to increase enrollment up to 1222 patients based on interim results.
Target Sample Size
1022
Trial Duration For Participant
120

Stratification factors

  • site
  • type of surgical procedure (coronary artery bypass graft, valve surgery, combined CABG/valve surgery)

Eligibility

Recruits 1022 The trial does not select vulnerable populations (isVulnerablePopulationSelected: false). Participants are adults (Adult ≥ 18 years) and must provide written informed consent. No minors are included and no assent procedures are described..

Pregnancy Exclusion
Pregnancy (a negative pregnancy test for women of childbearing age) or breastfeeding women
Vulnerable Population
The trial does not select vulnerable populations (isVulnerablePopulationSelected: false). Participants are adults (Adult ≥ 18 years) and must provide written informed consent. No minors are included and no assent procedures are described.

Inclusion criteria

  • {"criterion_text":"- Cardiac surgery using cardiopulmonary bypass including coronary artery bypass grafting (CABG) surgery, valve surgery, or combined CABG/valve surgery\n- Elevated risk of AKI as predicted by a score ≥ 1.5 on the following scale: a.\themoglobin < 130g/l \t\t= 2 b.\tcreatinine > 1.1 mg/dl \t= 2 c.\tage > 70 years \t\t=1.5 d.\tNYHA 4 \t\t\t=1.5 e.\tBMI > 30 \t\t\t=1.5\n- Adult ≥ 18 years\n- Written informed consent"}

Exclusion criteria

  • {"criterion_text":"- Major aortic surgery (aortic arch replacement), transplant surgery, pulmonary thrombendarterectomy, ventricular assist device placement\n- Persons with any kind of dependency on the investigator or employed by the sponsor/investigator\n- Participation in another interventional trial within the last three months that investigates kidney function\n- Already receiving inotropic/vasopressor support before surgery\n- Dialysis dependent\n- Pre-existing AKI within the last 30 days\n- Pre-existing chronic kidney injury with an eGFR<20 ml/min/1.73m2\n- Pre-existing significant hypertension (persistent SBP > 180mmHg)\n- Significant pulmonary hypertension (ePSAP > 70mmHg, mPAP > 40mmHg) with right ventricular systolic dysfunction (graded more severe than mild)\n- Hypersensitivity to the active substance or to any of the excipients of angiotensin II and norepinephrine (e.g. sodium metabisulfite, sulfite, chlorobutanol hemihydrate and sodium chloride and water)\n- Pregnancy (a negative pregnancy test for women of childbearing age) or breastfeeding women"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Rate of AKI KDIGO stage 2 or 3 or death within 72 hours after cardiac surgery","definition_or_measurement_approach":""}

Secondary endpoints

  • {"endpoint_text":"- MAKE90 (consisting of mortality, any dialysis within 90 days, persistent renal dysfunction (defined as > 25% eGFR reduction to baseline value at day 90)","definition_or_measurement_approach":"Composite endpoint consisting of mortality, any dialysis within 90 days, persistent renal dysfunction defined as >25% eGFR reduction to baseline value at day 90."}
  • {"endpoint_text":"- Development or progression of chronic kidney disease based on albuminuria and on two serum creatinine measurements between day 90 and 120","definition_or_measurement_approach":"Assessment based on albuminuria and two serum creatinine measurements taken between day 90 and day 120."}

Recruitment

Planned Sample Size
1022
Recruitment Window Months
27
Consent Approach
Written informed consent is required from adult participants. A subject information sheet and informed consent form for adults is listed (document: L1_SIS and ICF adults). No assent for minors is described and no specific languages for consent documents are specified in the available data.

Geography

Total Number Of Sites
15
Total Number Of Participants
1022

Germany

Earliest CTIS Part Ii Submission Date
15-01-2025
Latest Decision Or Authorization Date
09-07-2025
Processing Time Days
175
Number Of Sites
15
Number Of Participants
1022

Sites

Site Name
Universitaetsklinikum Wuerzburg AöR
Department Name
Klinik und Poliklinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie
Principal Investigator Name
Patrick Meybohm
Principal Investigator Email
Meybohm_P@ukw.de
Contact Person Name
Patrick Meybohm
Contact Person Email
Meybohm_P@ukw.de
Site Name
Klinikgruppe Dr. Guth GmbH & Co. KG
Department Name
Intensive Care Medicine; Heart- and Diabetes Center
Principal Investigator Name
Matthias Heringlake
Principal Investigator Email
heringlake@drguth.de
Contact Person Name
Matthias Heringlake
Contact Person Email
heringlake@drguth.de
Site Name
University Medical Center Hamburg-Eppendorf
Department Name
Klinik und Poliklinik für Anästhesiologie Zentrum für Anästhesiologie und Intensivmedizin
Principal Investigator Name
Bernd Saugel
Principal Investigator Email
b.saugel@uke.de
Contact Person Name
Bernd Saugel
Contact Person Email
b.saugel@uke.de
Site Name
Herzzentrum Dresden GmbH Universitaetsklinik
Department Name
Herzzentrum Dresden, TU Dresden
Principal Investigator Name
Klaus Matschke
Principal Investigator Email
Klaus.Matschke@herzzentrum-dresden.com
Contact Person Name
Klaus Matschke
Site Name
Universitaetsklinikum Bonn AöR
Department Name
University Hospital Bonn; Klinik für Anästhesiologie und Operative Intensivmedizin
Principal Investigator Name
Christian Bode
Principal Investigator Email
christian.bode@ukbonn.de
Contact Person Name
Christian Bode
Contact Person Email
christian.bode@ukbonn.de
Site Name
Friedrich-Schiller-Universitaet Jena
Department Name
Department of Anesthesiology and Intensive Care Medicine
Principal Investigator Name
Johannes Ehler
Principal Investigator Email
Johannes.Ehler@med.uni-jena.de
Contact Person Name
Johannes Ehler
Contact Person Email
Johannes.Ehler@med.uni-jena.de
Site Name
Universitaetsmedizin Goettingen
Department Name
Department of Anesthesiology
Principal Investigator Name
Reiner Wäschle
Principal Investigator Email
Reiner.Waeschle@med.uni-goettingen.de
Contact Person Name
Reiner Wäschle
Site Name
Deutsches Herzzentrum Muenchen Klinikum Der Technischen Universitaet Muenchen
Department Name
Klinik für Herz- und Gefäßchirurgie
Principal Investigator Name
Johannes Böhm
Principal Investigator Email
johannes.boehm@dhm.mhn.de
Contact Person Name
Johannes Böhm
Contact Person Email
johannes.boehm@dhm.mhn.de
Site Name
Universitaetsklinikum Tuebingen AöR
Department Name
Department of Anesthesiology and Intensive Care Medicine
Principal Investigator Name
Peter Rosenberger
Principal Investigator Email
peter.rosenberger@medizin.uni-tuebingen.de
Contact Person Name
Peter Rosenberger
Site Name
Universitaet Muenster
Department Name
Department of Anesthesiology, Intensive Care and Pain Medicine
Principal Investigator Name
Alexander Zarbock
Principal Investigator Email
zarbock@uni-muenster.de
Contact Person Name
Alexander Zarbock
Contact Person Email
zarbock@uni-muenster.de
Site Name
Universitaetsklinikum Essen AöR
Department Name
Klinik für Thorax- und Kardiovaskuläre Chirurgie, Westdeutsches Herz- und Gefässzentrum Essen
Principal Investigator Name
Matthias Thielmann
Principal Investigator Email
Matthias.Thielmann@uk-essen.de
Contact Person Name
Matthias Thielmann
Contact Person Email
Matthias.Thielmann@uk-essen.de
Site Name
Justus-Liebig-Universitaet Giessen
Department Name
Klinik für Herz-, Kinderherz- und Gefäßchirurgie
Principal Investigator Name
Andreas Böning
Principal Investigator Email
Andreas.Boening@chiru.med.uni-giessen.de
Contact Person Name
Andreas Böning
Site Name
Charite Universitaetsmedizin Berlin KöR
Department Name
Deutsches Herzzentrum der Charité - Klinik für Kardioanästhesiologie und Intensivmedizin
Principal Investigator Name
Christian Stoppe
Principal Investigator Email
christian.stoppe@charite-dhzc.de
Contact Person Name
Christian Stoppe
Site Name
Universitaetsklinikum Augsburg
Department Name
Department of Anesthesiology and Intensive Care Medicine
Principal Investigator Name
Philipp Simon
Principal Investigator Email
Philipp.Simon3@uk-augsburg.de
Contact Person Name
Philipp Simon
Contact Person Email
Philipp.Simon3@uk-augsburg.de
Site Name
Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz KöR
Department Name
Department of Anesthesiology
Principal Investigator Name
Eva Wittenmeier
Principal Investigator Email
Eva.Wittenmeier@unimedizin-mainz.de
Contact Person Name
Eva Wittenmeier

Sponsor

Primary sponsor

Full Name
Universitaet Muenster
Organisation Type
Educational Institution
Country Of Registered Address
Germany

Third parties

  • {"country":"","full_name":"PAION Deutschland GmbH","duties_or_roles":"Monetary support","organisation_type":""}
  • {"country":"","full_name":"Deutsche Forschungsgemeinschaft","duties_or_roles":"Monetary support","organisation_type":""}

Investigational products

Investigational Product Name
Giapreza 2.5 mg/ml concentrate for solution for infusion
Active Substance
Angiotensin II
Modality
Peptide/protein/enzyme
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
Authorised (marketing authorisation EU/1/19/1384/003)
Starting Dose
0.01 mg/ml (infusion bag containing Angiotensin II 0.01 mg/ml)
Maximum Dose
64.8 µg/Kg daily; max total 180 µg/Kg
Investigational Product Name
NOREPINEPHRINE
Active Substance
Noradrenaline tartrate
Modality
Small molecule
Routes Of Administration
Intravenous perfusion
Route
Intravenous perfusion
Starting Dose
0.1 mg/ml (infusion bag containing Norephinephrin 0.1 mg/ml)
Maximum Dose
4.3 mg/kg daily; max total 13 mg/kg

Related trials

Other published trials that may interest you.