Grant: Project Grant

A sudden decline in kidney function, called Acute Kidney Injury (AKI), is a common complication of critical illness. For patients with severe AKI, blood-cleaning dialysis treatments prevent death from kidney failure but do not heal the kidneys. In fact, dialysis itself often causes a drop in blood pressure. This drop in blood pressure can result in further damage to the kidneys, heart, brain, and other organs. Low blood pressure also prevents removal of excess body fluid during dialysis and this can result in critically ill patients needing treatment with a ventilator for longer. Overall, patients who experience low blood pressure during dialysis are at increased risk of death. Albumin is a protein normally found in blood. It helps maintain normal blood pressure. Intravenous albumin is a blood product that is sometimes given to patients during dialysis treatment to prevent low blood pressure and allow for fluid removal. How well this works is unknown. We will undertake a randomized trial that gives intravenous albumin or a placebo (saline) to consenting patients receiving dialysis treatments for AKI while critically ill in the intensive care unit. We aim to include 856 patients from 16 Canadian hospitals' intensive care units over 24 months. Ultimately, we seek to determine whether or not intravenous albumin helps patients recover more quickly from critical illness, improves kidney recovery, and reduces their risk of death. If intravenous albumin works then it could immediately be used widely to benefit critically ill patients that require dialysis for AKI. If it does not work, intravenous albumin is an expensive and limited resource and reducing its use in critically ill patients receiving dialysis for AKI would allow those resources to be used elsewhere within the healthcare system.