Improving Preterm Kidney Outcomes With Caffeine
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Caffeine citrate, Placebo.
- Who it may be relevant to
- Registry conditions: Kidney Injury, Pre-Term. Basic parameters: 12 Hours — 96 Hours · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Optimizing Caffeine Therapy for Hypoxia in Preterm Neonates: A Randomized Trial Assessing Efficacy, Acute Kidney and Brain Injury, Safety, and Pharmacokinetics
Overview
This study is being done to see if additional caffeine citrate (20 milligrams per kilogram IV bolus) helps babies with low kidney oxygenation already being treated with caffeine citrate (20 milligrams per kilogram IV bolus on day of life (DOL) 1 followed by 8 milligrams per kilogram daily maintenance). The investigators hypothesize that additional caffeine will improve kidney oxygen levels, while not causing any brain injury, and may reduce rates of acute kidney injury compared to placebo. This study will take place in preterm babies born less than 30 weeks gestational age, with the intervention occurring between greater than 48 hours of age until DOL 14 and outcomes tracked until neonatal intensive care unit (NICU) discharge.
Detailed description
The study population will consist of 114 preterm neonates born less than 30 weeks gestational age who have an intravenous (IV) line for which IV medications can be administered and who can have brain and kidney Near Infrared Spectroscopy (NIRS) monitoring.
Eligible participants will be enrolled between 12-96 hours of life after preterm birth and admission to the Meriter NICU. Baseline data will be collected and NIRS monitoring will be started when appropriate as determined by the team based on clinical guidelines and standard of care.
Those participants having kidney oxygenation less than 50 percent (and troubleshooting procedures have occurred and while ensuring brain oxygenation is not below 55 percent) after 48 hours and within the first 14 DOL will be randomized in a 1:1 manner to one of two treatment arms (Arm 1 and Arm 2).
* Arm 1: IV caffeine citrate (20 mg/kg) (n = 51) * Arm 2: Placebo - same volume of 0.9% Sodium Chloride United States Pharmacopeia (USP) (n=51)
Those participants who do not develop kidney hypoxia during the first 14 DOL will be the normal kidney oxygenation control group and receive no intervention (Arm 3).
* Arm 3: Normal Kidney oxygenation (no intervention) (Approximately n = 12)
Participant accrual will occur over 48 months. Participants will complete all study specific activities during the NICU hospitalization over the course of the first 28 DOL and clinical outcomes will be collected through NICU discharge or 6 months of age, whichever occurs first. Each participant will contribute blood specimens for creatinine and caffeine levels as well as approximately 20-40 urine samples for biomarker analysis.
Interventions
- Drug Caffeine citrate
intravenous (IV) caffeine citrate (20 milligrams per kilogram) followed by 8 milligrams per kilogram daily maintenance - Drug Placebo
same volume of 0.9 percent Sodium Chloride United States Pharmacopeia (USP)
Primary outcome measures
- Proportion of Participants with Improvement in Kidney Oxygenation [Time frame: Up to 3 hours post-intervention (Between days 1 and 17)]
Secondary outcome measures (2)
- Number of Days of Acute Kidney Injury (AKI) [Time frame: 14 days after intervention]
- Proportion of Participants with a Sustained Decrease in Cerebral Oxygenation [Time frame: up to 3 hours post-intervention (Between days 1 and 17)]
Eligibility criteria
Inclusion criteria
- Gestational age at birth between 23 0/7 and 29 6/7 weeks.
- Able to have near-infrared spectroscopy (NIRS) monitoring of cerebral and kidney oxygenation.
- Able to receive IV medications.
- Indwelling umbilical arterial catheter (UAC), umbilical venous catheter (UVC), peripheral arterial line (PAL), or peripherally inserted central catheter (PICC) already in place that can draw blood.
- Receiving caffeine at the time of enrollment
- Have a birth parent who is at least 18 years old and have a parent or guardian who is able to provide parental permission in English or Spanish
Exclusion criteria
- Known or suspected major congenital anomaly of the brain, heart, lungs or kidney (excluding UTD A1 pyelectasis).
- Known or suspected chromosomal or genetic anomaly.
- Not suitable for study participation due to other reasons at the discretion of the investigators.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Double blind
- Primary purpose
- Treatment
Study locations
United States · 1 center
- UW Hospital and Clinics — Madison
Identifiers
NCT: NCT07262060 · 2025-1079 · Protocol Version 3/8/2026 · SMPH\PEDIATRICS\NEONATO · 1R01HD116793-01