Clinical Trial Summary
Acute renal failure is a common complication in patients admitted to intensive care. Due to
the increasing incidence of acute renal failure, the use of Continuous Renal Replacement
Therapy (CRRT) is on the rise in the intensive care unit. The use of CRRT exposes patients to
some complications (bleeding, hemodynamic instability, antibiotic underdosing, malnutrition
and infections), justifying the importance of optimizing the quality and reliability of this
technique. Renal function is classically assessed by diuresis and creatinine. Creatinine
clearance is an indirect measure of glomerular filtration rate. Measuring creatinine
clearance is a simple, accessible and relatively inexpensive method. Traditionally,
clreatinine clearance has required 24-hour urine collection. However, it has been shown that
two-hour urine collection is also an accurate tool.
There is little information and few recommendations as to when to discontinue CRRT. A
predictive index for the withdrawal of CRRT would reduce the duration of treatment, reduce
complications and costs, and speed up patient rehabilitation.
Various parameters have been described as tools for deciding when to stop dialysis: diuresis
before stopping CRRT, urine and blood creatinine, daily urinary urea excretion, and sodium
and water balance. Among these factors, urine output and creatinine appear to be promising
predictive factors. The measurement of creatinine clearance combines these two factors and
can therefore be a good tool for predicting the return of adequate renal function.
Retrospective work carried out by Fröhlich et al in 2012 suggested that creatinine clearance
measured over 2 hours could be a good marker for successful withdrawal.
The hypothesis of the study is that creatinine clearance measured over 2 hours after stopping
CRRT is be predictive of the success of the withdrawal from this type of therapy.
