Acute Kidney InjuryPEAKNCT06471621
Precision Medicine in Cardiovascular Surgery Associated Acute Kidney Injury
An observational study of Acute Kidney Injury and Surgery-Complications, run by Insel Gruppe AG, University Hospital Bern at 1 site in Switzerland.
Trial summary
The goal of this prospective observational study is to define a risk profile for cardiovascular surgery associated acute kidney injury (AKI), using clinical patient characteristics, operation parameters as well as blood and urine laboratory values. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Acute Kidney Injury, Surgery-Complications, Frailty
- How many people
- 100 participants
- Where
- 1 siteSwitzerland
- Study dates
- 16 Jun 2024to 31 Oct 2026
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients undergoing elective cardiovascular surgery at the University Hospital Bern (Inselspital), Switzerland
Who may be able to join
- Patients undergoing elective cardiovascular surgery, such as valvular replacement surgery, with or without combined coronary artery bypass graft (CABG), or thoracic or abdominal aortic surgery.
- Written informed consent obtained prior to surgery.
Who cannot join
- Patients with a kidney transplant or on renal replacement therapy
- Severe liver failure, defined by the presence of encephalopathy, Factor V < 50% and INR >1.5 on preoperative blood sample (within 4 weeks).
Trial locations and contacts
1 site in 1 country.
Switzerland1 site, 1 recruiting
- Recruiting
University Hospital Bern (Inselspital)
Bern, 3010
Uyen Huynh-Do, Prof. MD, +41316323141, uyen.huynh-do@insel.ch
Stefan Rudloff, PhD, +41316329817, stefan.rudloff@unibe.ch
About this study
Official title: PrEcision Medicine in the Management of Cardiovascular Surgery Associated AKI - PEAK: a Prospective Observational Cohort Study
The goal of this prospective observational study is to define a risk profile for cardiovascular surgery associated acute kidney injury (AKI), using clinical patient characteristics, operation parameters as well as blood and urine laboratory values.
The main question it aims to answer is:
- Does a combination of the factors mentioned above better predict patient outcome than classical factors used to date in clinical practice?
Participants of this study are adults aged 18 and above who are scheduled for elective heart or main artery surgery, and who have given written informed consent.
Read the detailed description
The difficulty of precisely predicting AKI following major surgery is a clinical challenge and unmet need as treatment should be introduced within 24-48 hours. In addition there is no available treatment to date apart from supportive therapy such as renal replacement therapy.
Therefore, early identification of patient-specific biomarkers and other clinical predictors could help to better understand the association with AKI and other patient outcomes. In addition to the "classical" risk factors (age, diabetes, pre-existing CKD), frailty might represent another important variable, as shown in previous observational studies. Importantly frailty is not unique to age, although it occurs in approximately 25% of those over 65 and affects more than half of the population aged 85 and older, as it has been shown to be highly prevalent in hospitalized patients and/or patients with CKD. Furthermore, in preclinical studies the serum protein Fetuin-A was identified as potential biomarker for vascular surgery associated AKI.
PEAK is a single center, prospective observational study involving several clinics at the University Hospital Bern. Besides from demographic data and perioperative parameters, blood and urine are collected with high granularity during and immediately after surgery (15min after the first cut, start and end of cardiopulmonary bypass (CBP) or aortic clamping (X-clamp), 4 hours after surgery) and at day 1, 2, 3, and 7 (or discharge) post-surgery. In addition renal function will be assessed at day 90. Furthermore, study participants will answer the Edmonton frailty questionnaire at baseline and at day 90.
- Conditions
- Acute Kidney Injury, Surgery-Complications, Frailty
- Keywords
- Kidney, Renal, Cardiac, Thoracic, Abdominal, Valvular replacement, CABG, Aneurysm, cardiopulmonary bypass, Ischemia
- Medical subject headings
- Acute Kidney Injury, Frailty, Aneurysm, Ischemia
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from baseline of serum Fetuin-A values
Measurement of serum Fetuin-A at baseline and at the various sampling time-points mentioned above.
Measured: Baseline to day 90
Secondary outcomes (15)
BMI
Body mass index of participants in (kg/m2), integer: min 15 (extreme underweight), max 45 (extreme overweight)
Measured: Baseline and day 90
eGFR
estimated glomerular filtration rate in (ml/min)
Measured: Baseline and day 90
Proteinuria
Albumin in urine normalized to creatinine in categorized into 3 groups:
- <30 mg/d
- 30-300 mg/d
- >300 mg/d
Measured: Baseline and day 90
ASA score
American Society of Anesthesiology classification of physical status (1-6)
- - Normal health
- - Mild systemic disease
- - Severe systemic disease
- - Severe systemic disease that is constant threat to life
- - Moribund, not expected to survive 24h with or without operation
- - Declared brain-dead
Measured: Baseline
Euroscore II
Euroscore II, predicted mortality in (%)
Measured: Baseline
STS score (only for cardiac surgery)
Society of Thoracic Surgeons Score in (%), higher values predict higher risk
Measured: Baseline
Duration of ECC (only for cardiac surgery)
Time on extracorporeal circuit in (min)
Measured: Peri-operative
Duration of X-clamp (only for aortic surgery)
Time of X-clamping in (min)
Measured: Peri-operative
Lowest body temperature
Lowest body temperature recorded during surgery in (°C)
Measured: Peri-operative
SAPS II score
Simplified Acute Physiology Score (SAPS) II°C), in-hospital mortality at ICU admission, integer min 1, max 200, higher values predict higher mortality
Measured: After Operation to day 7
Urine output
Daily urine volume in (ml)
Measured: After Operation to day 7
Assessment of AKI incidence and severity at day 7 in association with change in serum Fetuin-A levels over time
AKI will be assessed as a binary outcome (presence/absence)
Biomarkers for AKI severity include levels of direct Fetuin-A targets, kidney function parameters, predictors of AKI or CKD (NGAL, suPAR, Nephrocheck®, or YKL-40), hemolysis (hemoglobin, transferrin), inflammatory mediators (cytokines, chemokines or growth factors), and exploratory assessments (proteomics, metabolomics).
Measured: Baseline to day 7
Assessment of AKI to CKD progression at day 90 in association with change in serum Fetuin-A levels over time
CKD will be evaluated as a binary outcome (presence/absence) based on renal functional parameters.
Measured: Baseline to day 90
Assessment of the patient-reported outcome measure (PROM) frailty in association with progression to CKD and worse clinical outcome
Frailty in terms of patient-related outcome will be reported as a paired difference of mean frailty score (Edmonton Frail Scale) between baseline and 90-days visit. The scale ranges from 0 (not frail) to 17 (severe frailty).
Measured: Baseline and day 90
Grip strength
Grip strength of dominant hand in kg
Measured: Baseline and day 90
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Jun 2024
- Study start16 Jun 2024
- Primary completion31 Jan 2026 (estimated)
- Study completion31 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Acute Kidney InjuryStudies of the same condition, open and under way.
- More trials run by Insel Gruppe AG, University Hospital BernThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Insel Gruppe AG, University Hospital Bern
- Sponsor type
- University, hospital or other
- Collaborators
- CSL Behring
- Responsible party
- Sponsor
- Investigators
- Uyen Huynh-Do, Prof. MD, Principal investigator, University Hospital Bern (Inselspital)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06471621
- Sponsor's protocol ID
- DLF-Nr: 5658
- Other IDs
- BASEC-Nr: 2023-02024
- Acronym
- PEAK
- Status last verified
- Jul 2024
- First submitted
- 24 Apr 2024
- Last updated
- 19 Jul 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Hammer N, Rudloff S, Waskowski J, Pfortmuller C, Pingpoh C, Chaikhouni B, Herzig S, Rheinberger M, Pedersen E, Luder G, Kotelis D, Siepe M, Erdoes G, Schefold J, Huynh-Do U. Protocol of the exploratory prospective observational PEAK study: PrEcision medicine in the management of cardiovascular surgery associated Acute Kidney Injury (AKI). BMJ Open. 2025 Jul 30;15(7):e095817. doi: 10.1136/bmjopen-2024-095817.
PubMed 40744512
Study at a glance
From the registry record, last updated by the sponsor on 19 Jul 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- PrEcision Medicine in the Management of Cardiovascular Surgery Associated AKI - PEAK: a Prospective Observational Cohort Study
- ClinicalTrials.gov ID
- NCT06471621
- Acronym / sponsor ID
- PEAK / DLF-Nr: 5658
- Conditions
- Acute Kidney Injury, Surgery-Complications, Frailty
- Keywords
- Kidney, Renal, Cardiac, Thoracic, Abdominal, Valvular replacement, CABG, Aneurysm
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- Insel Gruppe AG, University Hospital BernUniversity, hospital or other
- Collaborators
- CSL Behring
- Study start
- 16 Jun 2024 (actual)
- Primary completion
- 31 Jan 2026 (estimated)
- Study completion
- 31 Oct 2026 (estimated)
- First posted
- 24 Jun 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this prospective observational study is to define a risk profile for cardiovascular surgery associated acute kidney injury (AKI), using clinical patient characteristics, operation parameters as well as blood and urine laboratory values.
The main question it aims to answer is:
- Does a combination of the factors mentioned above better predict patient outcome than classical factors used to date in clinical practice?
Participants of this study are adults aged 18 and above who are scheduled for elective heart or main artery surgery, and who have given written informed consent.
Detailed description
The difficulty of precisely predicting AKI following major surgery is a clinical challenge and unmet need as treatment should be introduced within 24-48 hours. In addition there is no available treatment to date apart from supportive therapy such as renal replacement therapy.
Therefore, early identification of patient-specific biomarkers and other clinical predictors could help to better understand the association with AKI and other patient outcomes. In addition to the "classical" risk factors (age, diabetes, pre-existing CKD), frailty might represent another important variable, as shown in previous observational studies. Importantly frailty is not unique to age, although it occurs in approximately 25% of those over 65 and affects more than half of the population aged 85 and older, as it has been shown to be highly prevalent in hospitalized patients and/or patients with CKD. Furthermore, in preclinical studies the serum protein Fetuin-A was identified as potential biomarker for vascular surgery associated AKI.
PEAK is a single center, prospective observational study involving several clinics at the University Hospital Bern. Besides from demographic data and perioperative parameters, blood and urine are collected with high granularity during and immediately after surgery (15min after the first cut, start and end of cardiopulmonary bypass (CBP) or aortic clamping (X-clamp), 4 hours after surgery) and at day 1, 2, 3, and 7 (or discharge) post-surgery. In addition renal function will be assessed at day 90. Furthermore, study participants will answer the Edmonton frailty questionnaire at baseline and at day 90.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients undergoing elective cardiovascular surgery at the University Hospital Bern (Inselspital), Switzerland
Key inclusion criteria (2 listed)
- Patients undergoing elective cardiovascular surgery, such as valvular replacement surgery, with or without combined coronary artery bypass graft (CABG), or thoracic or abdominal aortic surgery.
- Written informed consent obtained prior to surgery.
Key exclusion criteria (2 listed)
- Patients with a kidney transplant or on renal replacement therapy
- Severe liver failure, defined by the presence of encephalopathy, Factor V < 50% and INR >1.5 on preoperative blood sample (within 4 weeks).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Change from baseline of serum Fetuin-A values
Time frame: Baseline to day 90
Measurement of serum Fetuin-A at baseline and at the various sampling time-points mentioned above.
15 secondary outcomes
BMI
Time frame: Baseline and day 90
eGFR
Time frame: Baseline and day 90
Proteinuria
Time frame: Baseline and day 90
ASA score
Time frame: Baseline
Euroscore II
Time frame: Baseline
STS score (only for cardiac surgery)
Time frame: Baseline
Duration of ECC (only for cardiac surgery)
Time frame: Peri-operative
Duration of X-clamp (only for aortic surgery)
Time frame: Peri-operative
Lowest body temperature
Time frame: Peri-operative
SAPS II score
Time frame: After Operation to day 7
Urine output
Time frame: After Operation to day 7
Assessment of AKI incidence and severity at day 7 in association with change in serum Fetuin-A levels over time
Time frame: Baseline to day 7
Assessment of AKI to CKD progression at day 90 in association with change in serum Fetuin-A levels over time
Time frame: Baseline to day 90
Assessment of the patient-reported outcome measure (PROM) frailty in association with progression to CKD and worse clinical outcome
Time frame: Baseline and day 90
Grip strength
Time frame: Baseline and day 90
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Jul 2024.
- Derived from this study: PubMed 40744512Hammer N, Rudloff S, Waskowski J, Pfortmuller C, Pingpoh C, Chaikhouni B, Herzig S, Rheinberger M, Pedersen E, Luder G, Kotelis D, Siepe M, Erdoes G, Schefold J, Huynh-Do U. Protocol of the exploratory prospective observational PEAK study: PrEcision medicine in the management of cardiovascular surgery associated Acute Kidney Injury (AKI). BMJ Open. 2025 Jul 30;15(7):e095817. doi: 10.1136/bmjopen-2024-095817.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Uyen Huynh-Do, Prof. MD principal investigator
University Hospital Bern (Inselspital)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Acute Kidney Injury and Surgery-Complications, run by Insel Gruppe AG, University Hospital Bern at 1 site in Switzerland.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 19 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Uyen Huynh-Do, Prof. MD (+41316323144, uyen.huynh-do@insel.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change from baseline of serum Fetuin-A values (time frame: Baseline to day 90). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06471621, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Jul 2024.