The Effect of Vasopressor Therapy on Renal Perfusion in Septic Shock

Last updated: April 1, 2025
Sponsor: King's College Hospital NHS Trust
Overall Status: Active - Recruiting

Phase

N/A

Condition

Low Blood Pressure (Hypotension)

Sepsis And Septicemia

Renal Failure

Treatment

Norepinephrine

Angiotensin II

Vasopressin

Clinical Study ID

NCT06234592
328797
  • Ages > 18
  • All Genders

Study Summary

Acute kidney injury (AKI) is a common complication of septic shock and together these conditions carry a high mortality risk. In septic patients who develop severe AKI renal cortical perfusion is deficient despite normal macrovascular organ blood flow. This intra-renal perfusion abnormality may be amenable to pharmacological manipulation, which may offer mechanistic insight into the pathophysiology of septic AKI. The aim of the current study is to investigate the effects of vasopressin and angiotensin II on renal microcirculatory perfusion in a cohort of patients with septic shock.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Within 48 hours of intensive care admission

  • Evidence of suspected or confirmed infection

  • Sequential Organ Failure (SOFA) score increase of 2 or more (assuming a baseline of 0 if no previous measures)

  • Requirement for norepinephrine infusion as the sole vasopressor agent in a dose of >0.1mcg/kg/min

  • Lactate >2mmol/L at any stage prior to randomisation

Exclusion

Exclusion Criteria:

  • Known intolerance to Sonovue™ contrast medium, vasopressin or angiotensin II

  • Patients receiving other vasoactive drugs in addition to norepinephrine

  • Patients with known chronic kidney disease (CKD) stage 4 or 5 (baseline glomerularfiltration rate (GFR) <30mls/min)

  • Patients receiving extra corporal membrane oxygenation (ECMO)

  • Patients with acute occlusive coronary syndromes requiring intervention

  • Patients with mesenteric ischaemia

  • Patients with a history or presence of aortic dissection or abdominal aorticaneurysm

  • Patients with Raynaud's syndrome or acute vaso-occlusive conditions

  • Pregnancy

Study Design

Total Participants: 45
Treatment Group(s): 3
Primary Treatment: Norepinephrine
Phase:
Study Start date:
January 05, 2024
Estimated Completion Date:
July 31, 2026

Connect with a study center

  • King's College Hospital

    London, SE5 9RS
    United Kingdom

    Active - Recruiting

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