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Pirfenidone Effect on the Recovery of Renal Function in Septic Acute Kidney Injury

Phase 4
Conditions
Acute Kidney Injury
Sepsis
Interventions
Drug: Placebo equivalent
Registration Number
NCT02530359
Lead Sponsor
Hospital Civil de Guadalajara
Brief Summary

Patients with Septic AKI will be randomized in three arms, group PFD 1,200 will receive PDF 600mg every 12 hrs per mouth, group PDF 600 will receive PFD 600mg in the morning and placebo equivalent at night and Group Placebo will receive placebo every 12 hrs, all for 7 days, all receive conventional treatment KDIGO guides. We analyze the recovery of renal function as a primary objective.

Detailed Description

Septic acute kidney injury (AKI) is the most common cause of AKI in the world, there is no specific treatment for this pathology; the pathophysiology is related to inflammatory pathway and strategies that modulate this are potentially useful. The Pirfenidone (PDF) is an anti-fibrotic and anti-inflammatory treatment, in animal models has shown a beneficial effect on the recovery of renal function immediately after administrated. The investigators propose a triple blind clinical trial,in which septic AKI patients will be randomized in three arms, all receive conventional treatment KDIGO guides, groupPDF 1,200 will receive PDF 600mg every 12 hrs per mouth, group PDF 600 will receive 600mg in the morning and placebo equivalent at night and Group Placebo will receive placebo every 12 hrs, all for 7 days. The Investigators analyze the recovery of renal function as a primary objective, as a secondary objectives clinical variables associated with renal recovery, biochemical variables, inflammatory, molecular variables and measurement of PDF in blood will be analyzed. Patients will be follow-up for 7 days and 28 days after randomization.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
90
Inclusion Criteria

. sepsis

  • AKI by serum creatinine, according to the KDIGO guide 2012 Acute Kidney Injury • acute on Chronic kidney disease (baseline creatinine <2 mg / dL)
Exclusion Criteria
  • Chronic kidney disease stage 3b, 4 or 5 (basal serum creatinine > 2mg/dl) known and / or sharpened.

    • chronic dialysis (peritoneal dialysis or hemodialysis)
    • History of AKI and / or RRT in the last three months
    • Pregnancy AKI by other causes other than sepsis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group 1Pirfenidone extended releasePirfenidone extended release 600mg per mouth every 12 hours for 7 days.
Group 2Placebo equivalentPirfenidone extended release 600mg per mouth in the morning and placebo by night (each treatment every 12 hrs) for 7 days.
Group 3Placebo equivalentPlacebo equivalent per mouth every 12 hrs for 7 days.
Group 2Pirfenidone extended releasePirfenidone extended release 600mg per mouth in the morning and placebo by night (each treatment every 12 hrs) for 7 days.
Primary Outcome Measures
NameTimeMethod
renal function recoverywithin the first 28 days

serum creatinine in serum \<2mg/dl and urinary output \>1,200ml/day

Secondary Outcome Measures
NameTimeMethod
Urinary Volumewithin the first 7 days

Urinary Volume in milliliters in 24 hours

serum urea levelswithin the first 7 days

serum urea levels in mg/dL

pirfenidone levels in serum ug/mLon day 1 and day 7

pirfenidone levels in serum ug/mL

need of renal replacement therapy (RRT)within the first 7 days

the patient still need renal replacement (RRT) by the judgment of the nephrologist.

mortalitywithin the first 7 days

the patient dead

serum creatinine levelswithin the first 7 days

serum creatinine levels in mg/dL

IL-1on day 1 and day 7

Interleucin 1 in serum pg/mL

IL-6on day 1 and day 7

Interleucin 6 in serum pg/mL

TNF-αon day 1 and day 7

tumor necrosis factor in serum pg/dL

Toll-like receptor 4on day 1 and day 7

Toll-like receptor 4 in serum pg/dL

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