Fluid Balance Guided by Modified Venous Excess Ultrasonography Versus Standard Care in Patients With Acute Kidney Injury Receiving Continuous Renal Replacement Therapy

Starting soon · Not applicable

Conditions studied: AKI - Acute Kidney Injury, Fluid Balance, Acute Circulatory Failure, Continuous Renal Replacement Therapy (CRRT), VExUS, Passive Leg Raising, Biomarkers / Blood

In brief

The goal of this randomised controlled trial is to compare the cumulative fluid balance over the first 72 h following inclusion guided by mVExUS versus standard of care in critically ill patients with acute kidney injury receiving CRKT . It will also compare the proportion of CRRT-related complications-including intradialytic hypotension and arrhythmias-between patients managed with mVExUS-guided fluid management and those receiving standard care. The main questions it aims to answer are: Does fluid removal rate guided by mVExUS will reduce cumulative fluid balance over the course of the first 72 h of CRRT in ICU patients compared to standard care Participants will: Get fluid assessment by mVExUS protocol or a strandard care every 8 hours for 72 hours

Key facts

Study ID

NCT07346118

Run by

Chulalongkorn University

People needed

126

Starts

2026-07-01

Expected to finish

2029-05-01

Last updated by the study team

2026-05-07

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Adults (≥ 18 years of age)
• Admitted to ICU
• Acute kidney injury by KDIGO criteria
• Initiated CRRT by at least one of the following indications for RRT initiation:
• Serum potassium ≥ 6.0 mmol/L, or
• pH ≤ 7.20 or serum bicarbonate ≤ 12 mmol/L, or
• Evidence of severe respiratory failure, based on a PaO2/FiO2 ≤ 200 and clinical perception of volume overload, or
• Persistent severe AKI (sCr remains > 50% the value recorded at randomization) for > 72 hours from randomization
• Participants giving informed consent

You may not qualify if…

• Refuse to participate
• Previous diagnosis of end-stage kidney disease (ESKD) currently on kidney replacement therapy
• Kidney transplant recipient
• Receive RRT before ICU admission within 90 days
• Structural kidney diseases which will interfere with intrarenal doppler ultrasound e.g. renal artery stenosis, autosomal dominant polycystic kidney disease
• Patients with previously known conditions that interfere with portal doppler assessment, namely liver cirrhosis, severe tricuspid regurgitation with structural heart disease or massive ascites.
• Underlying disease process with a life expectancy less than 90 days
• Pregnancy
• Severe cardiac rhythm disturbances (tachyarrhythmia, supraventricular tachycardia)
• Intra-cardiac shunts; Ventricle septal defect, patent foramen ovale, atrial septal defect
• Aortic aneurysm
• Intra-abdominal hypertension (intraabdominal pressure ≥20 mmHg)
• Expected life expectancy <48 hours
• Receiving extracorporeal membrane oxygenation (ECMO)

Full record on ClinicalTrials.gov

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