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Does High-dose Vitamin B3 Supplementation Prevent Major Adverse Kidney Events During Septic Shock?

Phase 3
Active, not recruiting
Conditions
Acute Kidney Injury
Septic Shock
Nicotinamide
Mortality
Interventions
Drug: placebo treatment
Registration Number
NCT04589546
Lead Sponsor
Centre Hospitalier Universitaire, Amiens
Brief Summary

Sepsis is the most common cause of acute kidney injury (AKI) in critically ill patients and is associated with a high mortality rate. Currently there is no available specific treatment to prevent or treat AKI in this setting. Many experimental and clinical data suggest that Nicotinamide, a safe and inexpensive vitamin, could be effective to prevent major adverse kidney events during septic shock. The main objective of the study is to show the superiority of Nicotinamide supplementation compared to the placebo group, in patients with septic shock admitted to intensive care. A 15% reduction in the incidence of major renal adverse events at day 30 is expected in the "Nicotinamide" group.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
310
Inclusion Criteria
  • Adult patients with septic shock defined as sepsis with persisting hypotension requiring vasopressors to maintain MAP ≥65 mm Hg and having a serum lactate level >2 mmol/L (18 mg/dL) despite adequate volume resuscitation.
  • Written informed consent
Exclusion Criteria
  • Presence of inclusion criteria for more than 24 hours
  • Immediate indication to start renal replacement therapy at the time of randomization: Hyperkalemia≥ 6.5 mmol /l, metabolic acidosis with pH <7.15 not controlled by medical treatment, diuretic resistant acute pulmonary edema or accumulation of a toxic requiring dialysis.
  • Formal indication of Nicotinamide supplementation according to the attending physician (eg pellagra, undernutrition, severe alcoholism)
  • Known severe chronic kidney disease (clearance <30 ml /min) in the last 3 months preceding the setic shock or kidney transplant recipient.
  • Moribund patient (estimated survival less than 24 hours)
  • Patient who are not expected to survive to day 30 due to terminal-stage disease (terminal respiratory or heart failure, Child C cirrhosis, uncontrolled cancer)
  • Resuscitated cardiac arrest
  • Pregnant or lactating
  • Legal tutorship and guardianship
  • Lack of social security coverage.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Vitamin B3Nicotinamide treatment-
Placeboplacebo treatment-
Primary Outcome Measures
NameTimeMethod
proportion of patients meeting one or more criteria for MAKE303 years after study start

MAKE30 is : in-hospital mortality, receipt of new RRT, or persistent renal dysfunction defined as a final inpatient serum creatinine value ≥2 time baseline serum creatinine

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

CHU Amiens

🇫🇷

Amiens, France

CHU Amiens
🇫🇷Amiens, France
Dimitri Titeca-Beauport, MD
Contact
0322456411
dimitri.titeca@chu-amiens.fr
Pierre-Louis DECLERCQ, MD
Sub Investigator
Hervé DUPONT, MD
Sub Investigator
Antoine RIVIERE, MD
Sub Investigator
Eloi GOULLIEUX, MD
Sub Investigator
Damien DUCHEYRON, MD
Sub Investigator
Bertrand SAUNEUF, MD
Sub Investigator
Steven GRANGE, MD
Sub Investigator
Patrick HERBECQ, MD
Sub Investigator
Christophe VINSONNEAU, MD
Sub Investigator
Thierry VAN DER LINDEN, MD
Sub Investigator
Olivier LEROY, MD
Sub Investigator
Maxime GRANIER, MD
Sub Investigator
Didier THEVENIN, MD
Sub Investigator
Joseph Bayekula, MD
Sub Investigator
Julien Maizel, Pr
Sub Investigator
Fabien LAMBIOTTE, MD
Sub Investigator

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