Clinical Trials Logo

Clinical Trial Summary

The aim of the study are: 1) To evaluate the occurrence of acid-base alterations and the incidence of hypophosphatemia during different modalities of Renal Replacement Terapy (RRT) in critically ill patients [CVVH, CVVHDF and SLED (Sustained Low-Efficiency Dialysis)] by using a simplified Regional Citrate Anticoagulation (RCA) protocol combined with the adoption of a phosphate-containing solution as dialysate and/or replacement fluid; 2) To optimize the infusion rates of different solutions adopted, including citrate, in order to obtain an appropriate electrolyte and buffer supply. The final aim of this approach will be to reduce the need for frequent monitoring of acid-base status and electrolytes (with special regard to ionized calcium levels), and to avoid the need for frequent adjustments of RCA-RRT parameters (infusion rate of different solutions, electrolytes supplementation in the course of RRT). This approach could allow to simplify anticoagulation protocols with citrate, in order to minimize potential concerns hampering a wider diffusion of RCA in daily practice.


Clinical Trial Description

The need for continuous anticoagulation represents a potential drawback of RRT modalities. KDIGO 2012 guidelines on acute kidney injury (AKI) suggest the adoption of RCA as first choice anticoagulation modality for continuous RRT (CRRT) in patients without contraindications for citrate. Citrate has been also introduced as anticoagulant for SLED and its use in the context of a mainly diffusive prolonged intermittent modality has been shown to represent an easy and safe method to maintain the extracorporeal circuit when concentrated citrate solutions, such as ACD-A are used. Hypophosphatemia is a known issue of RRT, and has been reported in up to 50-80% of cases when standard RRT solutions are used, especially in continuous/prolonged intermitted modalities when high RRT doses are delivered. RRT-related phosphate depletion should be avoided in critically ill patients due to the relevant hypophosphatemia-associated complications in this clinical setting. The adoption of phosphate-containing CRRT solutions could reduce the incidence of hypophosphatemia and minimize the need for parenteral phosphorus supplementation.The adoption of a commercially available phosphate-containing CRRT solution, in the setting of RCA-RRT may allow to meet the double target of minimizing RRT-induced hypophosphatemia and ensuring an adequate circuit life, also avoiding electrolyte and acid-base derangements. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03976440
Study type Observational
Source University of Parma
Contact
Status Active, not recruiting
Phase
Start date June 1, 2019
Completion date January 31, 2021

See also
  Status Clinical Trial Phase
Completed NCT01946113 - Mineral-Homeostasis in Continuous Renal Replacement Therapy N/A
Withdrawn NCT00993733 - Assessing the Impact of Two Methods of Continuous Veno-venous Hemodiafiltration on Time Nursing Work in Intensive Care N/A
Completed NCT01476995 - Prognostic Indicators as Provided by the EPIC ClearView N/A
Terminated NCT00978354 - Furosemide in Early Acute Kidney Injury Phase 2/Phase 3
Completed NCT00120263 - Trial of Plasma Exchange for Acute Renal Failure at the Onset of Myeloma N/A
Completed NCT04799600 - The Effect of the Severity of COVID-19 Disease on the Incidence of Acute Renal Failure in ICU
Recruiting NCT04334707 - Kidney Precision Medicine Project
Completed NCT02858531 - Predictive Tracking of Patient Flow in the Emergency Services During the Virus Winter Epidemics
Recruiting NCT05282732 - Retrospective Analysis of Performance and Treatment Data Collected for Genius SleddFlux Filter, Ultraflux AV 600 S Filter & Genius 90 Concentrates in Haemodialysis Patients
Completed NCT01467466 - Prevention of Serious Adverse Events Following Angiography Phase 3
Completed NCT01979042 - Urinary Markers for Unilateral Kidney Obstruction N/A
Completed NCT01280617 - Low Dose Thymoglobin in Renal Transplant Patients N/A
Completed NCT00780351 - Dosing Vancomycin in Patients on Sustained Low Efficiency Daily Hemodiafiltration (SLEDD-f) N/A
Completed NCT00971971 - Prevention of Intradialytic Hypotension in Acute Kidney Injury Patients N/A
Completed NCT00076219 - Acute Renal Failure Trial Network (ATN) Study Phase 3
Recruiting NCT04599569 - Influence of Renal Replacement TherApy on Indirect Calorimetry
Completed NCT03727204 - Acute Kidney Injury After Cardiac Surgery: Novel Ultrasound Techniques for Prediction of Acute Kidney Injury
Completed NCT06005896 - A Clinical Model for Dialysis Discontinuation in AKI
Completed NCT03004950 - Biomarker Effectiveness Analysis in Contrast Nephropathy (BEACON)
Completed NCT03627884 - Outcomes of the Use of Sodium Bicarbonate (8.4%) Solution as a Catheter Lock Solution to Prevent Hemodialysis Catheter Loss Due to Lumen Clot Formation Phase 4