Interest of the Echocardiography in the Management of Cirrhotic Patients With Acute Kidney Injury

Not Applicable

Completed

• Conditions: Cirrhosis; Hepatorenal Syndrome; Acute Kidney Injury; Diastolic Function
• Interventions: Procedure: Echocardiography

• Registration Number: NCT02097784
• Lead Sponsor: Hospices Civils de Lyon

Brief Summary

This prospective study focuses on the interest of the echocardiography for cirrhotic patients, who present acute kidney injury corresponding to the criteria of hepatorenal syndrome. This echocardiography will be done before the volemic expansion and the final diagnostic of hepatorenal syndrome or prerenal azotemia. The primary endpoint is to describe the hemodynamic characteristics of this population at the time of acute kidney injury and their association with diagnostic of hepatorenal syndrome or prerenal azotemia. Patients with elevated filling pressure, predicting poor outcome of volemic expansion will be excluded of the study after the echocardiography and will not undergo volemic expansion but appropriate management.

Detailed Description

Not available

Study Timeline

• Study Start: 2014-03
• Study First Submitted: 2014-03-24
• Study First Submitted QC: 2014-03-24
• Study First Posted: 2014-03-27
• Primary Completion: 2018-07
• Study Completion: 2018-07
• Status Verified: 2019-03
• Last Update Submitted: 2019-03-08
• Last Update Posted: 2019-03-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 28

Inclusion Criteria

• patients > 18 years
• written consent for the participation of the study
• cirrhosis with portal hypertension and ascite
• acute kidney injury according to AKIN criteria (rapid increase of creatinine (48 hours) > 26.4 µmol or > 50% comparing with baseline). Baseline creatinine is the last value of creatinine before admission or creatinine at the admission if stable during 5 days.
• absence of argument for acute tubular necrosis or other organic acute renal injury
• absence of argument for shock

Exclusion Criteria

• pregnant women
• volemic expansion before echocardiography
• portal thrombosis
• presence of TIPSS
• history of cardiac or renal pathology
• atrial fibrillation
• cardiac valvulopathy
• technical limitation due to echogenicity

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
cirrhosis with portal hypertension,ascite and acute kidney	Echocardiography	-

Primary Outcome Measures

Name	Time	Method
Hemodynamic features assessed by echocardiography before the volemic expansion of cirrhotic patients with acute renal injury corresponding to the criteria of hepatorenal syndrome.	At Day0 : at the time of diagnostic of acute kidney injury, before volemic expansion.	Systolic and diastolic function assessment, filling pressures, pulmonary arterial hypertension

Secondary Outcome Measures

Name	Time	Method
Tolerance of volemic expansion, as recommended by international guidelines	After 48 hours of volemic expansion	Clinical tolerance of volemic expansion, acute pulmonary oedema
Response to vasoconstrictor treatment of hepatorenal syndrome, in case of diagnostic of hepatorenal syndrome	1 month after inclusion	Renal function recovery, renal replacement therapy, liver transplantation
Mortality	1 month after inclusion

Trial Locations

Locations (1)

Hospices Civils de Lyon - Hôpital de la Croix-Rousse; 🇫🇷 Lyon, France