Timing of Renal Replacement Therapy In Mechanically Ventilated Patients

Alexandria University94 enrolled

Overview

This is a randomized controlled study that will be conducted on acute kidney injury (AKI) patients, who are mechanically ventilated, to assess the impact of implementation of early renal replacement therapy (RRT) compared to late RRT on patients outcome.

The study subjects will be randomly divided into two groups (arms). The first one will be patients who will receive early renal replacement therapy (RRT) according to predefined criteria that will be illustrated later. The other group of patients will be those who receive late RRT according to the absolute indications of emergency hemodialysis i.e. severe hyperkalemia, life-threatening acidosis, uremic encephalopathy or pericarditis in addition to intractable pulmonary edema. Appropriate randomization technique will be applied. A computer-based program will be used to perform the randomization procedure.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Timing of RRT in Mechanically Ventilated Patients

Interventions

Renal replacement therapyPROCEDURE

Renal replacement therapy (RRT) will be initiated in the early group for patients who have stage 2 AKI according to KDIGO classification. The late group will have RRT when they develop any of the absolute indications for RRT

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All patients must be on invasive mechanical ventilation. * Patients in AKI stage 2 , according to KDIGO classification. * Recruited subjects will include either those who present with AKI on their ICU admission or those who develop AKI during their ICU stay Exclusion Criteria: * Those who are known to be in grade 5 CKD according to KDIGO classification. All other grades of CKD from 1 to 4 will be included only if they develop or present with stage 2 AKI on top of their CKD grade * Those who develop AKI due to obstructive or traumatic causes. * Patients with septic shock who are on high doses of vasopressors or inotropes (norepinephrine infusion more than 1 mcg/kg/minute, dopamine or dobutamine infusion more than 5 mcg/kg/minute). * Pregnant females

Locations (1)

Alexandria Faculty of Medicine

Alexandria, Alexandria Governorate, Egypt

Outcomes

Primary Outcomes

mortality

ICU mortality

Time frame: 28 days

ICU length of stay

Duration of ICU stay

Time frame: through study completion, an average of 1 year

Weaning of mechanical ventilation

duration of mechanical ventilation

Time frame: through study completion, an average of 1 year

Secondary Outcomes

RRT dependency

Persistent need for renal replacement therapy for at least two sessions per week

Time frame: for more than three months

Renal functions on discharge from ICU

creatinine level on day of discharge from ICU

Time frame: through study completion, an average of 1 year

Data from ClinicalTrials.gov

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