Pirfenidone Effect on the Recovery of Renal Function in Septic Acute Kidney Injury (AKI)
Primary Purpose
Acute Kidney Injury, Sepsis
Status
Unknown status
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Pirfenidone extended release
Placebo equivalent
Sponsored by
About this trial
This is an interventional treatment trial for Acute Kidney Injury focused on measuring septic acute kidney injury, pirfenidone
Eligibility Criteria
Inclusion Criteria:
. sepsis
- AKI by serum creatinine, according to the KDIGO guide 2012 Acute Kidney Injury • acute on Chronic kidney disease (baseline creatinine <2 mg / dL)
Exclusion Criteria:
Chronic kidney disease stage 3b, 4 or 5 (basal serum creatinine > 2mg/dl) known and / or sharpened.
- chronic dialysis (peritoneal dialysis or hemodialysis)
- History of AKI and / or RRT in the last three months
- Pregnancy AKI by other causes other than sepsis
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Placebo Comparator
Arm Label
Group 1
Group 2
Group 3
Arm Description
Pirfenidone extended release 600mg per mouth every 12 hours for 7 days.
Pirfenidone extended release 600mg per mouth in the morning and placebo by night (each treatment every 12 hrs) for 7 days.
Placebo equivalent per mouth every 12 hrs for 7 days.
Outcomes
Primary Outcome Measures
renal function recovery
serum creatinine in serum <2mg/dl and urinary output >1,200 ml/day
renal function recovery
serum creatinine in serum <2mg/dl and urinary output >1,200ml/day
Secondary Outcome Measures
Urinary Volume
Urinary Volume in milliliters in 24 hours
need of renal replacement therapy (RRT)
the patient still need renal replacement (RRT) by the judgment of the nephrologist.
mortality
the patient dead
serum creatinine levels
serum creatinine levels in mg/dL
serum urea levels
serum urea levels in mg/dL
pirfenidone levels in serum ug/mL
pirfenidone levels in serum ug/mL
IL-1
Interleucin 1 in serum pg/mL
IL-6
Interleucin 6 in serum pg/mL
TNF-α
tumor necrosis factor in serum pg/dL
Toll-like receptor 4
Toll-like receptor 4 in serum pg/dL
Full Information
NCT ID
NCT02530359
First Posted
June 17, 2015
Last Updated
August 19, 2015
Sponsor
Hospital Civil de Guadalajara
1. Study Identification
Unique Protocol Identification Number
NCT02530359
Brief Title
Pirfenidone Effect on the Recovery of Renal Function in Septic Acute Kidney Injury
Acronym
AKI
Official Title
Pirfenidone Effect on the Recovery of Renal Function in Patients With Septic Acute Kidney Injury
Study Type
Interventional
2. Study Status
Record Verification Date
August 2015
Overall Recruitment Status
Unknown status
Study Start Date
October 2015 (undefined)
Primary Completion Date
March 2016 (Anticipated)
Study Completion Date
July 2016 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hospital Civil de Guadalajara
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Patients with Septic AKI will be randomized in three arms, group PFD 1,200 will receive PDF 600mg every 12 hrs per mouth, group PDF 600 will receive PFD 600mg in the morning and placebo equivalent at night and Group Placebo will receive placebo every 12 hrs, all for 7 days, all receive conventional treatment KDIGO guides. We analyze the recovery of renal function as a primary objective.
Detailed Description
Septic acute kidney injury (AKI) is the most common cause of AKI in the world, there is no specific treatment for this pathology; the pathophysiology is related to inflammatory pathway and strategies that modulate this are potentially useful. The Pirfenidone (PDF) is an anti-fibrotic and anti-inflammatory treatment, in animal models has shown a beneficial effect on the recovery of renal function immediately after administrated. The investigators propose a triple blind clinical trial,in which septic AKI patients will be randomized in three arms, all receive conventional treatment KDIGO guides, groupPDF 1,200 will receive PDF 600mg every 12 hrs per mouth, group PDF 600 will receive 600mg in the morning and placebo equivalent at night and Group Placebo will receive placebo every 12 hrs, all for 7 days. The Investigators analyze the recovery of renal function as a primary objective, as a secondary objectives clinical variables associated with renal recovery, biochemical variables, inflammatory, molecular variables and measurement of PDF in blood will be analyzed. Patients will be follow-up for 7 days and 28 days after randomization.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Kidney Injury, Sepsis
Keywords
septic acute kidney injury, pirfenidone
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
90 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Group 1
Arm Type
Active Comparator
Arm Description
Pirfenidone extended release 600mg per mouth every 12 hours for 7 days.
Arm Title
Group 2
Arm Type
Active Comparator
Arm Description
Pirfenidone extended release 600mg per mouth in the morning and placebo by night (each treatment every 12 hrs) for 7 days.
Arm Title
Group 3
Arm Type
Placebo Comparator
Arm Description
Placebo equivalent per mouth every 12 hrs for 7 days.
Intervention Type
Drug
Intervention Name(s)
Pirfenidone extended release
Intervention Description
Pirfenidone extended release 600mg per mouth
Intervention Type
Drug
Intervention Name(s)
Placebo equivalent
Other Intervention Name(s)
Placebo
Intervention Description
Placebo equivalent per mouth
Primary Outcome Measure Information:
Title
renal function recovery
Description
serum creatinine in serum <2mg/dl and urinary output >1,200 ml/day
Time Frame
within the first 7 days
Title
renal function recovery
Description
serum creatinine in serum <2mg/dl and urinary output >1,200ml/day
Time Frame
within the first 28 days
Secondary Outcome Measure Information:
Title
Urinary Volume
Description
Urinary Volume in milliliters in 24 hours
Time Frame
within the first 7 days
Title
need of renal replacement therapy (RRT)
Description
the patient still need renal replacement (RRT) by the judgment of the nephrologist.
Time Frame
within the first 7 days
Title
mortality
Description
the patient dead
Time Frame
within the first 7 days
Title
serum creatinine levels
Description
serum creatinine levels in mg/dL
Time Frame
within the first 7 days
Title
serum urea levels
Description
serum urea levels in mg/dL
Time Frame
within the first 7 days
Title
pirfenidone levels in serum ug/mL
Description
pirfenidone levels in serum ug/mL
Time Frame
on day 1 and day 7
Title
IL-1
Description
Interleucin 1 in serum pg/mL
Time Frame
on day 1 and day 7
Title
IL-6
Description
Interleucin 6 in serum pg/mL
Time Frame
on day 1 and day 7
Title
TNF-α
Description
tumor necrosis factor in serum pg/dL
Time Frame
on day 1 and day 7
Title
Toll-like receptor 4
Description
Toll-like receptor 4 in serum pg/dL
Time Frame
on day 1 and day 7
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
. sepsis
AKI by serum creatinine, according to the KDIGO guide 2012 Acute Kidney Injury • acute on Chronic kidney disease (baseline creatinine <2 mg / dL)
Exclusion Criteria:
Chronic kidney disease stage 3b, 4 or 5 (basal serum creatinine > 2mg/dl) known and / or sharpened.
chronic dialysis (peritoneal dialysis or hemodialysis)
History of AKI and / or RRT in the last three months
Pregnancy AKI by other causes other than sepsis
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jonathan Chavez, Dr
Phone
0443313299609
Email
jonarchi_10@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Guillermo Garcia, Dr
Phone
0443336622288
Email
ggarcia1952@gmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Juan Armenzadriz, Dr
Organizational Affiliation
Centro Universitario Ciencias de la Salud
Official's Role
Study Director
12. IPD Sharing Statement
Citations:
PubMed Identifier
20813868
Citation
Hsu CY. Where is the epidemic in kidney disease? J Am Soc Nephrol. 2010 Oct;21(10):1607-11. doi: 10.1681/ASN.2010050546. Epub 2010 Sep 2. No abstract available.
Results Reference
background
PubMed Identifier
23222124
Citation
Hsu RK, McCulloch CE, Dudley RA, Lo LJ, Hsu CY. Temporal changes in incidence of dialysis-requiring AKI. J Am Soc Nephrol. 2013 Jan;24(1):37-42. doi: 10.1681/ASN.2012080800. Epub 2012 Dec 6.
Results Reference
background
PubMed Identifier
19557705
Citation
James M, Pannu N. Methodological considerations for observational studies of acute kidney injury using existing data sources. J Nephrol. 2009 May-Jun;22(3):295-305.
Results Reference
background
PubMed Identifier
16106006
Citation
Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C; Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005 Aug 17;294(7):813-8. doi: 10.1001/jama.294.7.813.
Results Reference
background
PubMed Identifier
8605788
Citation
Brivet FG, Kleinknecht DJ, Loirat P, Landais PJ. Acute renal failure in intensive care units--causes, outcome, and prognostic factors of hospital mortality; a prospective, multicenter study. French Study Group on Acute Renal Failure. Crit Care Med. 1996 Feb;24(2):192-8. doi: 10.1097/00003246-199602000-00003.
Results Reference
background
PubMed Identifier
15458458
Citation
Mehta RL, Pascual MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TA, Paganini EP, Chertow GM; Program to Improve Care in Acute Renal Disease. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int. 2004 Oct;66(4):1613-21. doi: 10.1111/j.1523-1755.2004.00927.x.
Results Reference
background
PubMed Identifier
12205335
Citation
Metcalfe W, Simpson M, Khan IH, Prescott GJ, Simpson K, Smith WC, MacLeod AM; Scottish Renal Registry. Acute renal failure requiring renal replacement therapy: incidence and outcome. QJM. 2002 Sep;95(9):579-83. doi: 10.1093/qjmed/95.9.579.
Results Reference
background
PubMed Identifier
21814177
Citation
Grams ME, Rabb H. The distant organ effects of acute kidney injury. Kidney Int. 2012 May;81(10):942-948. doi: 10.1038/ki.2011.241. Epub 2011 Aug 3.
Results Reference
background
PubMed Identifier
21975865
Citation
Singbartl K, Kellum JA. AKI in the ICU: definition, epidemiology, risk stratification, and outcomes. Kidney Int. 2012 May;81(9):819-25. doi: 10.1038/ki.2011.339. Epub 2011 Oct 5.
Results Reference
background
PubMed Identifier
22547749
Citation
Heyman SN, Evans RG, Rosen S, Rosenberger C. Cellular adaptive changes in AKI: mitigating renal hypoxic injury. Nephrol Dial Transplant. 2012 May;27(5):1721-8. doi: 10.1093/ndt/gfs100.
Results Reference
background
PubMed Identifier
19759527
Citation
Heyman SN, Rosenberger C, Rosen S. Experimental ischemia-reperfusion: biases and myths-the proximal vs. distal hypoxic tubular injury debate revisited. Kidney Int. 2010 Jan;77(1):9-16. doi: 10.1038/ki.2009.347.
Results Reference
background
PubMed Identifier
24136922
Citation
Kinsey GR, Sharma R, Okusa MD. Regulatory T cells in AKI. J Am Soc Nephrol. 2013 Nov;24(11):1720-6. doi: 10.1681/ASN.2013050502. Epub 2013 Oct 17.
Results Reference
background
PubMed Identifier
24480828
Citation
Kaushal GP, Shah SV. Challenges and advances in the treatment of AKI. J Am Soc Nephrol. 2014 May;25(5):877-83. doi: 10.1681/ASN.2013070780. Epub 2014 Jan 30.
Results Reference
background
PubMed Identifier
11979336
Citation
Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis. 2002 May;39(5):930-6. doi: 10.1053/ajkd.2002.32766.
Results Reference
background
PubMed Identifier
21852670
Citation
Mehta RL. Management of acute kidney injury: it's the squeaky wheel that gets the oil! Clin J Am Soc Nephrol. 2011 Sep;6(9):2102-4. doi: 10.2215/CJN.07720811. Epub 2011 Aug 18. No abstract available.
Results Reference
background
PubMed Identifier
24586237
Citation
Yang F, Zhang L, Wu H, Zou H, Du Y. Clinical analysis of cause, treatment and prognosis in acute kidney injury patients. PLoS One. 2014 Feb 21;9(2):e85214. doi: 10.1371/journal.pone.0085214. eCollection 2014.
Results Reference
background
PubMed Identifier
21694939
Citation
Akcay A, Turkmen K, Lee D, Edelstein CL. Update on the diagnosis and management of acute kidney injury. Int J Nephrol Renovasc Dis. 2010;3:129-40. doi: 10.2147/IJNRD.S8641. Epub 2010 Sep 29.
Results Reference
background
PubMed Identifier
7491052
Citation
Brady HR, Singer GG. Acute renal failure. Lancet. 1995 Dec 9;346(8989):1533-40. doi: 10.1016/s0140-6736(95)92057-9. No abstract available.
Results Reference
background
PubMed Identifier
17038736
Citation
Hilton R. Acute renal failure. BMJ. 2006 Oct 14;333(7572):786-90. doi: 10.1136/bmj.38975.657639.AE. No abstract available.
Results Reference
background
PubMed Identifier
16495376
Citation
Waikar SS, Curhan GC, Wald R, McCarthy EP, Chertow GM. Declining mortality in patients with acute renal failure, 1988 to 2002. J Am Soc Nephrol. 2006 Apr;17(4):1143-50. doi: 10.1681/ASN.2005091017. Epub 2006 Feb 22.
Results Reference
background
PubMed Identifier
9077523
Citation
Chiao H, Kohda Y, McLeroy P, Craig L, Housini I, Star RA. Alpha-melanocyte-stimulating hormone protects against renal injury after ischemia in mice and rats. J Clin Invest. 1997 Mar 15;99(6):1165-72. doi: 10.1172/JCI119272.
Results Reference
background
PubMed Identifier
22913596
Citation
Thompson JD, Kornbrust DJ, Foy JW, Solano EC, Schneider DJ, Feinstein E, Molitoris BA, Erlich S. Toxicological and pharmacokinetic properties of chemically modified siRNAs targeting p53 RNA following intravenous administration. Nucleic Acid Ther. 2012 Aug;22(4):255-64. doi: 10.1089/nat.2012.0371.
Results Reference
background
PubMed Identifier
22306733
Citation
Sugimoto H, LeBleu VS, Bosukonda D, Keck P, Taduri G, Bechtel W, Okada H, Carlson W Jr, Bey P, Rusckowski M, Tampe B, Tampe D, Kanasaki K, Zeisberg M, Kalluri R. Activin-like kinase 3 is important for kidney regeneration and reversal of fibrosis. Nat Med. 2012 Feb 5;18(3):396-404. doi: 10.1038/nm.2629.
Results Reference
background
Citation
24. A study to evaluate the safety and efficacy of AC607 for the treatment of kidney injury in cardiac surgery subjects (ACT-AKI).
Results Reference
background
PubMed Identifier
21844075
Citation
Briguori C, Visconti G, Focaccio A, Airoldi F, Valgimigli M, Sangiorgi GM, Golia B, Ricciardelli B, Condorelli G; REMEDIAL II Investigators. Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II): RenalGuard System in high-risk patients for contrast-induced acute kidney injury. Circulation. 2011 Sep 13;124(11):1260-9. doi: 10.1161/CIRCULATIONAHA.111.030759. Epub 2011 Aug 15.
Results Reference
background
PubMed Identifier
22269279
Citation
Pickkers P, Heemskerk S, Schouten J, Laterre PF, Vincent JL, Beishuizen A, Jorens PG, Spapen H, Bulitta M, Peters WH, van der Hoeven JG. Alkaline phosphatase for treatment of sepsis-induced acute kidney injury: a prospective randomized double-blind placebo-controlled trial. Crit Care. 2012 Jan 23;16(1):R14. doi: 10.1186/cc11159.
Results Reference
background
PubMed Identifier
18272842
Citation
Tumlin J, Wali R, Williams W, Murray P, Tolwani AJ, Vinnikova AK, Szerlip HM, Ye J, Paganini EP, Dworkin L, Finkel KW, Kraus MA, Humes HD. Efficacy and safety of renal tubule cell therapy for acute renal failure. J Am Soc Nephrol. 2008 May;19(5):1034-40. doi: 10.1681/ASN.2007080895. Epub 2008 Feb 13.
Results Reference
background
PubMed Identifier
23106607
Citation
Tumlin JA, Chawla L, Tolwani AJ, Mehta R, Dillon J, Finkel KW, DaSilva JR, Astor BC, Yevzlin AS, Humes HD. The effect of the selective cytopheretic device on acute kidney injury outcomes in the intensive care unit: a multicenter pilot study. Semin Dial. 2013 Sep-Oct;26(5):616-23. doi: 10.1111/sdi.12032. Epub 2012 Oct 29.
Results Reference
background
PubMed Identifier
22442183
Citation
Faubel S, Chawla LS, Chertow GM, Goldstein SL, Jaber BL, Liu KD; Acute Kidney Injury Advisory Group of the American Society of Nephrology. Ongoing clinical trials in AKI. Clin J Am Soc Nephrol. 2012 May;7(5):861-73. doi: 10.2215/CJN.12191111. Epub 2012 Mar 22.
Results Reference
background
PubMed Identifier
9143872
Citation
Taniyama M, Ohbayashi S, Narita M, Nakazawa R, Hasegawa S, Azuma N, Teraoka S, Ota K, Yamauchi S, Margolin SB. Pharmacokinetics of an antifibrotic agent, pirfenidone, in haemodialysis patients. Eur J Clin Pharmacol. 1997;52(1):77-8. doi: 10.1007/s002280050252. No abstract available.
Results Reference
background
PubMed Identifier
12371954
Citation
Sutton TA, Fisher CJ, Molitoris BA. Microvascular endothelial injury and dysfunction during ischemic acute renal failure. Kidney Int. 2002 Nov;62(5):1539-49. doi: 10.1046/j.1523-1755.2002.00631.x.
Results Reference
background
PubMed Identifier
11818695
Citation
Okusa MD. The inflammatory cascade in acute ischemic renal failure. Nephron. 2002 Feb;90(2):133-8. doi: 10.1159/000049032.
Results Reference
background
PubMed Identifier
18802372
Citation
Kinsey GR, Li L, Okusa MD. Inflammation in acute kidney injury. Nephron Exp Nephrol. 2008;109(4):e102-7. doi: 10.1159/000142934. Epub 2008 Sep 18.
Results Reference
background
PubMed Identifier
15232604
Citation
Schrier RW, Wang W, Poole B, Mitra A. Acute renal failure: definitions, diagnosis, pathogenesis, and therapy. J Clin Invest. 2004 Jul;114(1):5-14. doi: 10.1172/JCI22353. Erratum In: J Clin Invest. 2004 Aug;114(4):598.
Results Reference
background
PubMed Identifier
8618585
Citation
Thadhani R, Pascual M, Bonventre JV. Acute renal failure. N Engl J Med. 1996 May 30;334(22):1448-60. doi: 10.1056/NEJM199605303342207. No abstract available.
Results Reference
background
PubMed Identifier
9853246
Citation
Star RA. Treatment of acute renal failure. Kidney Int. 1998 Dec;54(6):1817-31. doi: 10.1046/j.1523-1755.1998.00210.x.
Results Reference
background
PubMed Identifier
7573008
Citation
Conger JD. Interventions in clinical acute renal failure: what are the data? Am J Kidney Dis. 1995 Oct;26(4):565-76. doi: 10.1016/0272-6386(95)90590-1.
Results Reference
background
PubMed Identifier
12411754
Citation
Ronco C, Bellomo R. Prevention of acute renal failure in the critically ill. Nephron Clin Pract. 2003 Jan;93(1):C13-20. doi: 10.1159/000066646.
Results Reference
background
PubMed Identifier
10651214
Citation
Kelly KJ, Molitoris BA. Acute renal failure in the new millennium: time to consider combination therapy. Semin Nephrol. 2000 Jan;20(1):4-19.
Results Reference
background
PubMed Identifier
9648068
Citation
Shimizu T, Kuroda T, Hata S, Fukagawa M, Margolin SB, Kurokawa K. Pirfenidone improves renal function and fibrosis in the post-obstructed kidney. Kidney Int. 1998 Jul;54(1):99-109. doi: 10.1046/j.1523-1755.1998.00962.x.
Results Reference
background
PubMed Identifier
11783601
Citation
Hewitson TD, Kelynack KJ, Tait MG, Martic M, Jones CL, Margolin SB, Becker GJ. Pirfenidone reduces in vitro rat renal fibroblast activation and mitogenesis. J Nephrol. 2001 Nov-Dec;14(6):453-60.
Results Reference
background
PubMed Identifier
15729167
Citation
Shihab FS, Bennett WM, Yi H, Andoh TF. Effect of pirfenidone on apoptosis-regulatory genes in chronic cyclosporine nephrotoxicity. Transplantation. 2005 Feb 27;79(4):419-26. doi: 10.1097/01.tp.0000151721.99418.48.
Results Reference
background
PubMed Identifier
20006961
Citation
Takakuta K, Fujimori A, Chikanishi T, Tanokura A, Iwatsuki Y, Yamamoto M, Nakajima H, Okada M, Itoh H. Renoprotective properties of pirfenidone in subtotally nephrectomized rats. Eur J Pharmacol. 2010 Mar 10;629(1-3):118-24. doi: 10.1016/j.ejphar.2009.12.011. Epub 2009 Dec 13.
Results Reference
background
PubMed Identifier
23002925
Citation
Takakura K, Tahara A, Sanagi M, Itoh H, Tomura Y. Antifibrotic effects of pirfenidone in rat proximal tubular epithelial cells. Ren Fail. 2012;34(10):1309-16. doi: 10.3109/0886022X.2012.718955. Epub 2012 Sep 24. Erratum In: Ren Fail: 2012;34(10):1316.
Results Reference
background
PubMed Identifier
23152296
Citation
Chen JF, Ni HF, Pan MM, Liu H, Xu M, Zhang MH, Liu BC. Pirfenidone inhibits macrophage infiltration in 5/6 nephrectomized rats. Am J Physiol Renal Physiol. 2013 Mar 15;304(6):F676-85. doi: 10.1152/ajprenal.00507.2012. Epub 2012 Nov 14.
Results Reference
background
Citation
46. Hartung J: A note on combining dependent tests of significance. Biometrical J 1999, 41:849-855.
Results Reference
background
PubMed Identifier
20809935
Citation
Macias-Barragan J, Sandoval-Rodriguez A, Navarro-Partida J, Armendariz-Borunda J. The multifaceted role of pirfenidone and its novel targets. Fibrogenesis Tissue Repair. 2010 Sep 1;3:16. doi: 10.1186/1755-1536-3-16.
Results Reference
background
PubMed Identifier
17906160
Citation
Shi S, Wu J, Chen H, Chen H, Wu J, Zeng F. Single- and multiple-dose pharmacokinetics of pirfenidone, an antifibrotic agent, in healthy Chinese volunteers. J Clin Pharmacol. 2007 Oct;47(10):1268-76. doi: 10.1177/0091270007304104.
Results Reference
background
PubMed Identifier
20050822
Citation
Cho ME, Kopp JB. Pirfenidone: an anti-fibrotic therapy for progressive kidney disease. Expert Opin Investig Drugs. 2010 Feb;19(2):275-83. doi: 10.1517/13543780903501539.
Results Reference
background
PubMed Identifier
15640628
Citation
Panacek EA, Marshall JC, Albertson TE, Johnson DH, Johnson S, MacArthur RD, Miller M, Barchuk WT, Fischkoff S, Kaul M, Teoh L, Van Meter L, Daum L, Lemeshow S, Hicklin G, Doig C; Monoclonal Anti-TNF: a Randomized Controlled Sepsis Study Investigators. Efficacy and safety of the monoclonal anti-tumor necrosis factor antibody F(ab')2 fragment afelimomab in patients with severe sepsis and elevated interleukin-6 levels. Crit Care Med. 2004 Nov;32(11):2173-82. doi: 10.1097/01.ccm.0000145229.59014.6c.
Results Reference
background
PubMed Identifier
9851930
Citation
Poltorak A, He X, Smirnova I, Liu MY, Van Huffel C, Du X, Birdwell D, Alejos E, Silva M, Galanos C, Freudenberg M, Ricciardi-Castagnoli P, Layton B, Beutler B. Defective LPS signaling in C3H/HeJ and C57BL/10ScCr mice: mutations in Tlr4 gene. Science. 1998 Dec 11;282(5396):2085-8. doi: 10.1126/science.282.5396.2085.
Results Reference
background
PubMed Identifier
10196138
Citation
Chow JC, Young DW, Golenbock DT, Christ WJ, Gusovsky F. Toll-like receptor-4 mediates lipopolysaccharide-induced signal transduction. J Biol Chem. 1999 Apr 16;274(16):10689-92. doi: 10.1074/jbc.274.16.10689.
Results Reference
background
PubMed Identifier
15155619
Citation
Samuelsson P, Hang L, Wullt B, Irjala H, Svanborg C. Toll-like receptor 4 expression and cytokine responses in the human urinary tract mucosa. Infect Immun. 2004 Jun;72(6):3179-86. doi: 10.1128/IAI.72.6.3179-3186.2004.
Results Reference
background
PubMed Identifier
16332927
Citation
El-Achkar TM, Huang X, Plotkin Z, Sandoval RM, Rhodes GJ, Dagher PC. Sepsis induces changes in the expression and distribution of Toll-like receptor 4 in the rat kidney. Am J Physiol Renal Physiol. 2006 May;290(5):F1034-43. doi: 10.1152/ajprenal.00414.2005. Epub 2005 Dec 6.
Results Reference
background
PubMed Identifier
14764737
Citation
Cunningham PN, Wang Y, Guo R, He G, Quigg RJ. Role of Toll-like receptor 4 in endotoxin-induced acute renal failure. J Immunol. 2004 Feb 15;172(4):2629-35. doi: 10.4049/jimmunol.172.4.2629.
Results Reference
background
PubMed Identifier
16316333
Citation
Patole PS, Schubert S, Hildinger K, Khandoga S, Khandoga A, Segerer S, Henger A, Kretzler M, Werner M, Krombach F, Schlondorff D, Anders HJ. Toll-like receptor-4: renal cells and bone marrow cells signal for neutrophil recruitment during pyelonephritis. Kidney Int. 2005 Dec;68(6):2582-7. doi: 10.1111/j.1523-1755.2005.00729.x.
Results Reference
background
PubMed Identifier
24378526
Citation
Morrell ED, Kellum JA, Hallows KR, Pastor-Soler NM. Epithelial transport during septic acute kidney injury. Nephrol Dial Transplant. 2014 Jul;29(7):1312-9. doi: 10.1093/ndt/gft503. Epub 2013 Dec 29.
Results Reference
background
PubMed Identifier
18922884
Citation
Leelahavanichkul A, Yasuda H, Doi K, Hu X, Zhou H, Yuen PS, Star RA. Methyl-2-acetamidoacrylate, an ethyl pyruvate analog, decreases sepsis-induced acute kidney injury in mice. Am J Physiol Renal Physiol. 2008 Dec;295(6):F1825-35. doi: 10.1152/ajprenal.90442.2008. Epub 2008 Oct 15.
Results Reference
background
PubMed Identifier
14531793
Citation
Miyaji T, Hu X, Yuen PS, Muramatsu Y, Iyer S, Hewitt SM, Star RA. Ethyl pyruvate decreases sepsis-induced acute renal failure and multiple organ damage in aged mice. Kidney Int. 2003 Nov;64(5):1620-31. doi: 10.1046/j.1523-1755.2003.00268.x.
Results Reference
background
PubMed Identifier
22586448
Citation
Chatterjee PK, Yeboah MM, Dowling O, Xue X, Powell SR, Al-Abed Y, Metz CN. Nicotinic acetylcholine receptor agonists attenuate septic acute kidney injury in mice by suppressing inflammation and proteasome activity. PLoS One. 2012;7(5):e35361. doi: 10.1371/journal.pone.0035361. Epub 2012 May 7.
Results Reference
background
PubMed Identifier
25575158
Citation
Morrell ED, Kellum JA, Pastor-Soler NM, Hallows KR. Septic acute kidney injury: molecular mechanisms and the importance of stratification and targeting therapy. Crit Care. 2014 Sep 2;18(5):501. doi: 10.1186/s13054-014-0501-5.
Results Reference
background
PubMed Identifier
18382186
Citation
Hoste EA, Schurgers M. Epidemiology of acute kidney injury: how big is the problem? Crit Care Med. 2008 Apr;36(4 Suppl):S146-51. doi: 10.1097/CCM.0b013e318168c590.
Results Reference
background
PubMed Identifier
23353941
Citation
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R; Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013 Feb;41(2):580-637. doi: 10.1097/CCM.0b013e31827e83af.
Results Reference
background
PubMed Identifier
19066848
Citation
Bagshaw SM, Lapinsky S, Dial S, Arabi Y, Dodek P, Wood G, Ellis P, Guzman J, Marshall J, Parrillo JE, Skrobik Y, Kumar A; Cooperative Antimicrobial Therapy of Septic Shock (CATSS) Database Research Group. Acute kidney injury in septic shock: clinical outcomes and impact of duration of hypotension prior to initiation of antimicrobial therapy. Intensive Care Med. 2009 May;35(5):871-81. doi: 10.1007/s00134-008-1367-2. Epub 2008 Dec 9.
Results Reference
background
PubMed Identifier
21734090
Citation
Plataki M, Kashani K, Cabello-Garza J, Maldonado F, Kashyap R, Kor DJ, Gajic O, Cartin-Ceba R. Predictors of acute kidney injury in septic shock patients: an observational cohort study. Clin J Am Soc Nephrol. 2011 Jul;6(7):1744-51. doi: 10.2215/CJN.05480610.
Results Reference
background
PubMed Identifier
33520317
Citation
Chavez-Iniguez JS, Poo JL, Ibarra-Estrada M, Garcia-Benavides L, Navarro-Blackaller G, Cervantes-Sanchez C, Nungaray-Pacheco E, Medina-Gonzalez R, Armendariz-Borunda J, Garcia-Garcia G. Effect of Prolonged-Release Pirfenidone on Renal Function in Septic Acute Kidney Injury Patients: A Double-Blind Placebo-Controlled Clinical Trial. Int J Nephrol. 2021 Jan 13;2021:8833278. doi: 10.1155/2021/8833278. eCollection 2021.
Results Reference
derived
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Pirfenidone Effect on the Recovery of Renal Function in Septic Acute Kidney Injury
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