Urine Alkalinisation in COVID-19
Primary Purpose
Covid19, Acute Kidney Injury
Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Sodium bicarbonate
standard care
Sponsored by
About this trial
This is an interventional prevention trial for Covid19
Eligibility Criteria
Inclusion Criteria:
- Confirmed Covid-19 positive
- Admission to Critical Care Unit
- Bladder catheter in situ
- Central line in place
- Age ≥18y
- Written informed consent to participate in the study
Exclusion Criteria:
- Stage 3 AKI (as defined by Kidney Disease Improving Global Outcome criteria)
- Chronic kidney disease stage 4 or 5
- Contraindications to NaHCO3 therapy (e.g. risk of serious drug interaction, systemic metabolic alkalosis, congestive heart failure)
- Urine pH > 7.5
- Serum sodium >150mmol/L
- Blood pressure >180/100mgHg
- Severe hypokalaemia (K<3.0mmol/L)
- Severe hypocalcaemia (Cai <0.8 mmol/L)
- Pregnant or lactating and breast-feeding women
- Patient is on a medication that may interact with sodium bicarbonate
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
sodium bicarbonate
control
Arm Description
iv sodium bicarbonate 8.4%
standard care
Outcomes
Primary Outcome Measures
urinary alkalisation
urine pH >7.5
Secondary Outcome Measures
acute kidney injury
creatinine rise as defined by KDIGO criteria
Full Information
NCT ID
NCT04806061
First Posted
March 15, 2021
Last Updated
March 17, 2021
Sponsor
Guy's and St Thomas' NHS Foundation Trust
Collaborators
University of Pittsburgh
1. Study Identification
Unique Protocol Identification Number
NCT04806061
Brief Title
Urine Alkalinisation in COVID-19
Official Title
Urine Alkalinisation to Prevent AKI in COVID-19
Study Type
Interventional
2. Study Status
Record Verification Date
March 2021
Overall Recruitment Status
Unknown status
Study Start Date
April 15, 2021 (Anticipated)
Primary Completion Date
May 15, 2022 (Anticipated)
Study Completion Date
December 31, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Guy's and St Thomas' NHS Foundation Trust
Collaborators
University of Pittsburgh
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Since the outbreak of coronavirus disease 2019 (COVID-19), more than 100,000 patients have died in the United Kingdom. Acute kidney injury is common in critically ill patients with COVID-19. It is associated with a high risk of dying. At present, it is not clear how to prevent or treat kidney failure in these patients.
Recent research has shown that the coronavirus can directly infect kidney issue. It uses a particular protein on the cell surface (the ACE2 receptor) for entry into cells. Entry into cells is easier if the blood is more acidic.
The aim of this project is to find out whether urinary alkalisation using intravenous bicarbonate is feasible and can reduce the risk of acute kidney injury in critically ill patients with COVID-19.
Detailed Description
Acute kidney injury (AKI) is common in patients with Coronavirus disease 2019 (COVID-19). Research has shown that the SARS-CoV-2 virus can directly infect kidney issue via the Angiotensin-converting-enzyme 2 receptor which is pH dependent. The aim of this randomised controlled feasibility study is to explore whether urinary alkalisation using intravenous bicarbonate is feasible and can reduce the risk of acute kidney injury in critically ill patients with COVID-19.
Critically ill patients with COVID-19 and no AKI will be randomised to intravenous NaHCO3 8.4% versus standard care for up to 10 days.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Covid19, Acute Kidney Injury
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
open label randomised controlled trial
Masking
None (Open Label)
Allocation
Randomized
Enrollment
80 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
sodium bicarbonate
Arm Type
Experimental
Arm Description
iv sodium bicarbonate 8.4%
Arm Title
control
Arm Type
Experimental
Arm Description
standard care
Intervention Type
Drug
Intervention Name(s)
Sodium bicarbonate
Other Intervention Name(s)
sodium bicarbonate 8.4%
Intervention Description
sodium bicarbonate 8.4% to achieve urinary pH >7.5
Intervention Type
Drug
Intervention Name(s)
standard care
Other Intervention Name(s)
usual care
Intervention Description
standard care
Primary Outcome Measure Information:
Title
urinary alkalisation
Description
urine pH >7.5
Time Frame
10 days
Secondary Outcome Measure Information:
Title
acute kidney injury
Description
creatinine rise as defined by KDIGO criteria
Time Frame
28 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Confirmed Covid-19 positive
Admission to Critical Care Unit
Bladder catheter in situ
Central line in place
Age ≥18y
Written informed consent to participate in the study
Exclusion Criteria:
Stage 3 AKI (as defined by Kidney Disease Improving Global Outcome criteria)
Chronic kidney disease stage 4 or 5
Contraindications to NaHCO3 therapy (e.g. risk of serious drug interaction, systemic metabolic alkalosis, congestive heart failure)
Urine pH > 7.5
Serum sodium >150mmol/L
Blood pressure >180/100mgHg
Severe hypokalaemia (K<3.0mmol/L)
Severe hypocalcaemia (Cai <0.8 mmol/L)
Pregnant or lactating and breast-feeding women
Patient is on a medication that may interact with sodium bicarbonate
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Marlies Ostermann, PhD
Phone
00442071887188
Ext
83038
Email
Marlies.Ostermann@gstt.nhs.uk
First Name & Middle Initial & Last Name or Official Title & Degree
Nuttha Lumlertgul, PhD
Phone
00442071887188
Ext
83038
Email
Nuttha.Lumlertgul@gstt.nhs.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marlies Ostermann, PhD
Organizational Affiliation
Guy's & St Thomas Hospital
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
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Urine Alkalinisation in COVID-19
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