Citrate anticoagulation is becoming the gold standard in dialysis in intensive care units. It is now accepted that citrate prolongs the life of filters with a lower risk of bleeding. However, the management of citrate is complex. Optimization is based on citrate flow, blood flow and the amount of calcium reinjected. Frequently the citrate level is sub-dosed.Currently, the fraction of excretion of citrate by the hemodialysis machine is unknown. Knowing this information would allow, if it is important enough, to add an additional parameter of citrate management by adapting the level of dialysis. The determination of citrate in an extracorporeal circulation circuit has already been performed and has been validated in the literature. We propose to perform the assay on subjects with the same starting parameters, in order to deduce the clearance of citrate.
Study Type
OBSERVATIONAL
Enrollment
100
Patients are dialysed according to the standard of care. Biological variables are measured in pre-filter, post-filter and dialysate 30 minutes after the dialysis is initiated.
CHU Brugmann
Brussels, Belgium
RECRUITINGCitrate concentration - pre-filter
Citrate concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Citrate concentration - post-filter
Citrate concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Citrate concentration - dialysate
Citrate concentration in a blood sample taken in the dialysate
Time frame: 30 minutes after the start of dialysis
Age
Age
Time frame: Baseline
Weight
Weight
Time frame: Baseline
Height
Height
Time frame: Baseline
Sex
Sex
Time frame: Baseline
Apache II score
The APACHE II score is calculated at the beginning of the intensive care unit admission to help determine the patient's mortality risk for the admission. An integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death.
Time frame: Baseline
SOFA (Sequential Organ Failure Assessment) score
The Sequential Organ Failure Assessment score (SOFA score), is used in intensive care units to determine and track the status of a patient with organ failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems. Higher scores mean a higher risk of mortality.
Time frame: Baseline
Glomerular filtration rate (GFR)
Glomerular filtration rate
Time frame: Baseline
Creatinin level
Creatinin level
Time frame: Baseline
Diuresis
Volume of urinary secretion in the last 12 hours
Time frame: Baseline
KDIGO classification
The KDIGO classification defines 3 stages of increasing severity for acute kidney injuries.
Time frame: Baseline
Na (sodium) concentration -pre-filter
Na (sodium) concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Na (sodium) concentration -post-filter
Na (sodium) concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Cl (chlorine) concentration - pre-filter
Cl (chlorine) concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Cl (chlorine) concentration -post-filter
Cl (chlorine) concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
K (potassium) concentration - pre-filter
K (potassium) concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
K (potassium) concentration - post-filter
K (potassium) concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Total Ca (calcium) concentration -pre-filter
Ca (calcium) concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Total Ca (calcium) concentration -post-filter
Ca (calcium) concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Total Ca (calcium) concentration -dialysate
Ca (calcium) concentration in the dialysate
Time frame: 30 minutes after the start of dialysis
Ionized calcium (Ca2+) concentration -pre-filter
Ca (calcium) concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Ionized calcium (Ca2+) concentration -post-filter
Ca (calcium) concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Ionized calcium (Ca2+) concentration -dialysate
Ca (calcium) concentration in the dialysate
Time frame: 30 minutes after the start of dialysis
Mg (magnesium) concentration - pre-filter
Mg (magnesium) concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Mg (magnesium) concentration - post-filter
Mg (magnesium) concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
PO4 (phosphate) concentration - pre-filter
PO4 (phosphate) concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
PO4 (phosphate) concentration - post-filter
PO4 (phosphate) concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Lactate concentration - pre-filter
Lactate blood concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Lactate concentration - post-filter
Lactate blood concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Albumin concentration -pre-filter
Albumin concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Albumin concentration -post-filter
Albumin concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
pH - pre-filter
pH of a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
pH - post-filter
pH of a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Total C-reactive protein (CRP) -pre-filter
Total CRP concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Total C-reactive protein (CRP) -post-filter
Total CRP concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Total C-reactive protein (CRP) -dialysate
Total CRP concentration in a blood sample taken in the dialysate
Time frame: 30 minutes after the start of dialysis
Monomeric C-reactive protein (CRP) -pre-filter
Monomeric CRP concentration in a blood sample taken before the dialysis filter
Time frame: 30 minutes after the start of dialysis
Monomeric C-reactive protein (CRP) -post-filter
Monomeric CRP concentration in a blood sample taken after the dialysis filter
Time frame: 30 minutes after the start of dialysis
Monomeric C-reactive protein (CRP) -dialysate
Monomeric CRP concentration in a blood sample taken in the dialysate
Time frame: 30 minutes after the start of dialysis
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