LIBERation From AcuTE Dialysis

Description

The goal of the LIBERATE-D clinical trial is to improve outcomes for patients recovering from dialysis-requiring acute kidney injury (AKI-D). The impact of a conservative dialysis strategy compared to standard clinical practice of thrice-weekly dialysis will be examined to help generate knowledge for how to guide delivery of dialysis to facilitate renal recovery.Dialysis-requiring acute kidney injury (AKI-D) is a devastating complication among hospitalized patients for which there are no treatments other than supportive care. Recovery of sufficient renal function to stop dialysis is an unequivocally important clinical and patient-oriented outcome. Shortening dialysis duration and increasing the number of AKI-D patients who recover would have a major clinical, public health and cost-saving impact. However, there is currently no evidence to guide the delivery of dialysis to facilitate recovery. The investigators hypothesize that in patients who have AKI-D and who are hemodynamically stab

Trial Eligibility

Inclusion Criteria: * ≥ 18 years of age * Inpatient with AKI-D (intermittent hemodialysis or continuous renal replacement therapy received on at least one calendar day) at least partially due t acute tubular necrosis per the clinical nephrology team * Hemodynamic stability: not requiring vasopressor support and with planned intermittent dialysis * Baseline estimated glomerular filtration rate (eGFR) ≥ 15 mL/min/1.73 m2 Exclusion Criteria: * Nontraditional indication for dialysis (end-stage liver disease awaiting transplantation, fulminant hepatic failure, intoxication) * Complete nephrectomy as cause of AKI-D * Kidney transplant during index hospitalization * Dialysis \> 3 months * Decompensated heart failure requiring left ventricular assist device or continuous inotropic support * Mechanical ventilation via endotracheal tube * Hypoxemia requiring significant oxygen support: \>5 liters/min via nasal cannula or equivalent via face mask/tracheostomy mask to maintain oxygen saturation \> 95%, or requiring fraction of inspired oxygen \>50% in patients with tracheostomy requiring invasive or non-invasive ventilation * Unable to consent and no surrogate decisionmaker available * Pregnant * Prisoner * Clinical team declines to allow study participation * Anticipated discharge or transfer from study hospital within 48 hours

Study Info

Interventions

Locations Recruiting

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