Abstract
Background Acute kidney injury (AKI) is a global public health challenge resulting in considerable morbidity and mortality. AKI on chronic kidney disease (CKD) (AKI on CKD, A on C) accounts for about a third of total AKI. For severe AKI grade 3, renal replacement therapy (RRT) should be implemented in time. However, the lack of recognized drug treatment method for AKI grades 1–2 is a crucial problem in clinic. Chuan Huang Fang (CHF) is a Chinese herbal formulation developed for the treatment of A on C from the Shanghai Municipal Hospital of Traditional Chinese Medicine. Our previous studies suggested that CHF might effectively protect renal functions of A on C patients. As a widely used antioxidant in clinic, reduced glutathione (RG) is reported to improve the clinical efficacy of high-flux hemodialysis (HFHD) in severe AKI patients recently. To address the crucial problem mentioned above, thus we design a new clinical protocol of CHF combining RG and try to evaluate the efficacy and safety of this protocol in treating patients diagnosed with CKD stages 2–4 complicated with AKI grades 1–2. Methods This is a multicenter randomized controlled clinical trial. We intend to enroll 162 participants, and these participants will be divided into the RG group, the CHF group, and the RG + CHF group randomly assigning 1 : 1 : 1 principle. The RG group will be general treatments combining RG, the CHF group will be general treatments combining CHF, and the RG + CHF group will be general treatments combining RG and CHF. The duration of treatment will last two weeks. The primary evaluation outcome will be the change in the slope of serum creatinine (Scr) over 2 weeks. Secondary evaluation outcomes include changes in blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinary AKI biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), gamma-glutamyl transpeptidase (γ-GT), etc.), traditional Chinese medicine (TCM) symptoms, inflammatory indicators, and oxidative stress indicators. Meanwhile, the vital sign indicators and adverse events (AEs) will be closely observed. These dates will be meticulously recorded and properly handled by investigators throughout the study. Discussion. This study will provide convictive research-derived data to evaluate clinical efficacy and safety of CHF combing RG for CKD stages 2–4 complicated with AKI grades 1–2 and provide an evidence-based recommendation for clinicians. The timely completion of this trial will provide a novel drug treatment method for A on C. This trial is registered with ChiCTR2100043311 and registered on February 9, 2021.
Highlights
Acute kidney injury (AKI) is defined as an abrupt decrease in kidney function, which encompasses both structural damage and functional loss [1]
reduced glutathione (RG) is reported to improve the clinical efficacy of high-flux hemodialysis (HFHD) in patients with severe AKI [32, 33]. erefore, we plan to further optimize the original protocol, using Chuan Huang Fang (CHF) combining RG to form a new treatment method and carry out such a multicenter randomized controlled clinical trial on chronic kidney disease (CKD) stages 2–4 complicated with AKI grades 1–2 to evaluate the clinical efficacy and safety of this new method. e timely completion of this trial will provide a novel drug treatment method for A on C
Patients diagnosed with CKD stages 2–4 complicated with AKI grades 1–2 will be enrolled after signing written informed consents. ey will be randomly divided into the RG group, the CHF group, and the RG + CHF group
Summary
Acute kidney injury (AKI) is a global public health challenge resulting in considerable morbidity and mortality. For severe AKI grade 3, renal replacement therapy (RRT) should be implemented in time. The lack of recognized drug treatment method for AKI grades 1–2 is a crucial problem in clinic. To address the crucial problem mentioned above, we design a new clinical protocol of CHF combining RG and try to evaluate the efficacy and safety of this protocol in treating patients diagnosed with CKD stages 2–4 complicated with AKI grades 1–2. Secondary evaluation outcomes include changes in blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinary AKI biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), gamma-glutamyl transpeptidase (c-GT), etc.), traditional Chinese medicine (TCM) symptoms, inflammatory indicators, and oxidative stress indicators. Is study will provide convictive research-derived data to evaluate clinical efficacy and safety of CHF combing RG for CKD stages 2–4 complicated with AKI grades 1–2 and provide an evidence-based recommendation for clinicians. Discussion. is study will provide convictive research-derived data to evaluate clinical efficacy and safety of CHF combing RG for CKD stages 2–4 complicated with AKI grades 1–2 and provide an evidence-based recommendation for clinicians. e timely completion of this trial will provide a novel drug treatment method for A on C. is trial is registered with ChiCTR2100043311 and registered on February 9, 2021
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