Effects of Different Continuous Renal Replacement Therapy Patterns on Ionized Calcium in Patients With Citrate Anticoagulants Using Calcium-containing Replacement Solutions
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: CVVH, CVVHD.
- Who it may be relevant to
- Registry conditions: Renal Injury, Regional Citrate Anticoagulation, Continuous Renal Replacement Therapy. Basic parameters: 18 years — 100 years · 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
- China
- 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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Overview
It is unclear whether different modes of continuous renal replacement therapy (CRRT) impact post-filter ionized calcium concentrations during regional citrate anticoagulation (RCA) when using calcium-containing replacement fluid. This prospective, single-center, observational cohort study will screen all patients receiving CRRT for eligibility. General clinical information will be collected before commencing CRRT treatment. Patients will be randomly assigned to either the veno-venous hemofiltration (CVVH) or continuous veno-venous hemodialysis (CVVHD) group and switch to the alternative mode in the subsequent treatment session. Pre-filter and post-filter ionized calcium, systemic total and ionized calcium, and effluent total and ionized calcium will be measured 2 hours after the initiation of CRRT. Electrolyte levels, arterial blood gases, hourly citrate dose, and total citrate dose will be recorded every 6 hours until the end of CRRT. The primary outcome is the difference in ionized calcium concentrations at each site over time between the two modes.
Interventions
- Procedure CVVH
CVVH therapy - Procedure CVVHD
CVVHD therapy
Primary outcome measures
- Post-filter iCa [Time frame: 2 hours after the initiation of CRRT]
- Serum iCa [Time frame: 2 hours after the initiation of CRRT]
- Serum Ca2+ [Time frame: 2 hours after the initiation of CRRT]
- Effluent Ca2+ [Time frame: 2 hours after the initiation of CRRT]
Secondary outcome measures (1)
- Incidence of new-onset metabolic complications [Time frame: 48 hours after the initiation of CRRT]
Eligibility criteria
Inclusion criteria
- Age ≥ 18 years old;
- Receiving citrate anticoagulation;
- Obtain Informed consent from patients or next of kin.
Exclusion criteria
- Pregnant or lactating women;
- Allergic to citrate anticoagulants;
- Severe liver dysfunction (total bilirubin levels exceeding two times the normal range);
- Hypoxemia (PaO2 < 60 mmHg);
- Inadequate tissue perfusion (blood pressure < 90/60 mmHg despite high doses of vasoactive agents);
- Hyperlactatemia (lactate> 4 mmol/L);
- Hypernatremia;
- Estimated length of hospital stay < 48h;
- Participated in other studies.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Case-crossover
Study locations
China · 1 center
- Fujian Provincial Hospital — Fuzhou
Identifiers
NCT: NCT06021080 · HChen