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Trial registered on ANZCTR
Registration number
ACTRN12617001461381
Ethics application status
Approved
Date submitted
17/09/2017
Date registered
16/10/2017
Date last updated
16/10/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
GELATIne fluid and acute kidney injury in critical illness: the GELATI trial
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Scientific title
The effect of 4% succinylated gelatine fluid on acute kidney injury in critically ill patients
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Secondary ID [1]
292841
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
GELATI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Critical illness
304684
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Circulatory failure
304754
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Acute kidney injury
304934
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Condition category
Condition code
Cardiovascular
303996
303996
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0
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Other cardiovascular diseases
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Renal and Urogenital
304264
304264
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0
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Other renal and urogenital disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravenous 4% succinylated gelatine fluid at a dose of at least 500mL, to be delivered over less than 60 minutes, Exact dose will be determined by treating physician. The study fluid will also be used for any further fluid boluses required within the next 24-hour period, up to a maximum of 50mL/kg or 3000mL. Any fluid required for blood volume expansion beyond 24 hours is open-label; however, the use of gelatine will be not allowed for 7 days post-enrolment. Other crystalloid fluids or blood products may be used for purposes other than blood volume expansion, such as maintenance requirements or transfusion. Use of albumin solution is also permitted, if specifically indicated. Volume and type of all fluids delivered with 7 days of enrolment, or until ICU discharge, will be recorded.
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Intervention code [1]
299088
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Treatment: Drugs
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Comparator / control treatment
Intravenous compound sodium lactate at a dose of at least 500mL, to be delivered over less than 60 minutes, Exact dose will be determined by treating physician. The study fluid will also be used for any further fluid boluses required within the next 24-hour period, up to a maximum of 50mL/kg or 3000mL.
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Control group
Active
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Outcomes
Primary outcome [1]
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A difference in the change in urine NGAL concentrations over time after first dose of study fluid
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Assessment method [1]
303328
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Timepoint [1]
303328
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0, 1, 5 and 24 hours
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Primary outcome [2]
303544
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A difference in the change in urine cystatin C concentrations over time after first dose of study fluid
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Assessment method [2]
303544
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Timepoint [2]
303544
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0, 1, 5 and 24 hours
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Secondary outcome [1]
338654
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Urinary F2-isoprostanes concentration
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Assessment method [1]
338654
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Timepoint [1]
338654
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0, 1, 5 and 24 hours
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Secondary outcome [2]
338655
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Maximum KDIGO AKI stage within 7 days after randomisation
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Assessment method [2]
338655
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Timepoint [2]
338655
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7 days
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Secondary outcome [3]
338656
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RRT-free days within 28 days after randomisation
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Assessment method [3]
338656
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Timepoint [3]
338656
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28 days
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Secondary outcome [4]
338657
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60-day all-cause mortality
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Assessment method [4]
338657
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Timepoint [4]
338657
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60 days
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Secondary outcome [5]
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Urinary a1-microglobulin concentration
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Assessment method [5]
339287
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Timepoint [5]
339287
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0, 1, 5, and 24 hours
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Secondary outcome [6]
339288
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ICU-free days within 28 days after randomisation
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Assessment method [6]
339288
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Timepoint [6]
339288
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28 days
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Eligibility
Key inclusion criteria
1. Patient within 96 hours of ICU admission
2. Treating physician has made a clinical decision to administer a fluid bolus at a dose of at least 500mL delivered over <60 minutes
3. Presence of a urinary collection system
4. Treating physician believes there is an equipoise in using either GELO or CSL for intravascular volume expansion.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. When an intravenous fluid bolus is not intended or planned on a clinical ground
2. Age <18 years old
3. Imminent death and/or limitation of care order
4. Severe chronic renal failure (creatinine >265µmol/L prior to acute illness, or end-stage renal failure receiving chronic dialysis)
5. Urine output <10mL/hr over the previous 4 hours
6. Currently receiving RRT, or planned RRT within the next 24 hours
7. Known allergy to GELO
8. Has received GELO in the previous 48 hours
9. Patient has been admitted to ICU for longer than 96 hours
10. Previous enrolment in the study
11. Treating clinician perceives that participation in the study is not in the patient’s best interests
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Numbered sealed envelope
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomised block design of 4 blocks per treatment arm (2x4, 2x6) generated by statistical package software (Stata, College Station, TX, USA).
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety
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Statistical methods / analysis
Change in biomarker concentration over time will be compared between the placebo and GELO groups using a linear treatment effects model with propensity scoring adjustment for APACHE II score and admission diagnosis group. For biomarkers with skewed distributions that are resistant to successful transformation, quantile regression will be employed to compare differences over time. Ordinal logistic regression methods will be used for testing differences in maximum AKI stage, and logistic regression for differences in binary clinical outcomes.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
30/11/2017
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Actual
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Date of last participant enrolment
Anticipated
30/11/2018
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Actual
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Date of last data collection
Anticipated
31/01/2019
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [2]
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
17463
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6150 - Murdoch
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Recruitment postcode(s) [2]
17464
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6000 - Perth
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Funding & Sponsors
Funding source category [1]
297474
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Charities/Societies/Foundations
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Name [1]
297474
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Royal Perth Hospital Medical Research Foundation
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Address [1]
297474
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76 Murray St Perth, WA 6000
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Country [1]
297474
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
Royal Perth Hospital Medical Research Foundation
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Address
76 Murray St Perth, WA 6000
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Country
Australia
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Secondary sponsor category [1]
296470
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None
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Name [1]
296470
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Address [1]
296470
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Country [1]
296470
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298577
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South Metropolitan Health Service Ethics Committee
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Ethics committee address [1]
298577
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Level 3, Harry Perkins Institute of Medical Research, Fiona Stanley Hospital 11 Robin Warren Drive, MURDOCH WA 6150
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Ethics committee country [1]
298577
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Australia
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Date submitted for ethics approval [1]
298577
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01/04/2017
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Approval date [1]
298577
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31/08/2017
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Ethics approval number [1]
298577
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RGS0000000105
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Summary
Brief summary
Synthetic colloid fluids are frequently used for blood volume expansion in critically ill patients. Starch-based synthetic colloid fluids have been associated with increased risk of acute kidney injury. There is some evidence that gelatine-based colloid fluids may also pose a similar risk. This randomised open-label controlled pilot trial will assess the effects of 4% succinylated gelatine fluid on urinary biomarkers of acute kidney injury in Intensive Care Unit (ICU) patients. This study will also assess clinical outcomes, as secondary endpoints, including change in AKI stage, need for renal replacement therapy (RRT), ICU length of stay and mortality.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Kwok Ming Ho
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Address
77534
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Intensive Care Unit, Royal Perth Hospital
Wellington St
Perth, WA, 6001
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Country
77534
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Australia
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Phone
77534
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+618 92241056
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Fax
77534
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Email
77534
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[email protected]
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Contact person for public queries
Name
77535
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Lisa Smart
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Address
77535
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Murdoch University
90 South St
Murdoch, WA 6150
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Country
77535
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Australia
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Phone
77535
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+618 9360 6692
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Fax
77535
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Email
77535
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[email protected]
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Contact person for scientific queries
Name
77536
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Lisa Smart
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Address
77536
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Murdoch University
90 South St
Murdoch, WA 6150
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Country
77536
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Australia
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Phone
77536
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+618 9360 6692
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Fax
77536
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Email
77536
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A randomised controlled trial of succinylated gelatin (4%) fluid on urinary acute kidney injury biomarkers in cardiac surgical patients.
2021
https://dx.doi.org/10.1186/s40635-021-00412-9
N.B. These documents automatically identified may not have been verified by the study sponsor.
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