A Prompt REstart Study of Renin-Angiotensin System Inhibitors After Acute Kidney Injury

Conditions

• Acute Kidney Injury

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Not accepted

Interventions

• Early RASi restart strategy — DRUG
  The early restart strategy is to resume RASi as soon as the serum creatinine (SCr) downtrends by ≥0.3mg/dL from peak. In addition, the following criteria must be met: most recent potassium ≤5mEq/L, CKD-EPI SCr-based eGFR reported as ≥15 mL/min/1.73m2, and average SBP ≥120mmHg 12 hours prior to restart. If the study participant is discharged from the hospital before the RASi restart criteria are met, management of RASi restart would be deferred to the discretion of longitudinal outpatient healthcare team.
• Usual Care — DRUG
  RASi restart will be deferred to the study participant's providers.

Study Details

The goal of this pilot clinical trial is to learn if early restart of renin-angiotensin system inhibitor (RASi) medications is feasible and well-tolerated in hospitalized patients with acute kidney injury (AKI). Researchers will compare early RASi restart to usual care. Study participants will restart RASi per study protocol, obtain a lab test in 1-2 weeks if RASi restarted in the hospital and not collected as part of routine care, and answer questions at the 90-day follow-up.

Key Dates

First listed

Jul 29, 2026

Start date

Aug 31, 2026

Status verified

Jul 2026

Primary completion

Mar 31, 2029

Completion

Mar 31, 2029

Study Design

Enrollment

60 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Arms

• Active Comparator: Usual care
  RASi restart will be deferred to the study participant's providers.
• Experimental: Early RASi restart strategy
  The early restart strategy is to resume RASi as soon as the serum creatinine (SCr) downtrends by ≥0.3mg/dL from peak. In addition, the following criteria must be met: most recent potassium ≤5mEq/L, SCr-based eGFR reported as ≥15 mL/min/1.73m2, and average systolic blood pressure≥120mmHg 12 hours prior to restart. If the study participant is discharged from the hospital before the RASi restart criteria are met, management of RASi restart would be deferred to the discretion of longitudinal outpatient healthcare team.

Primary Outcome Measure

Feasibility- RASi use separation [ Time Frame: From date of enrollment until date of hospital discharge or up to 90 days if remains in the hospital ]

Central Contacts

• Yuenting D Kwong, MD MAS
  415-514-7371
  [email protected]

Locations (1)

Find similar trials in San Francisco, CA

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