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.
Study Type
OBSERVATIONAL
Enrollment
30
CVVH therapy
CVVHD therapy
Fujian Provincial Hospital
Fuzhou, Fujian, China
RECRUITINGPost-filter iCa
The post-filter ionized calcium concentration
Time frame: 2 hours after the initiation of CRRT
Serum iCa
Serum ionized calcium concentration
Time frame: 2 hours after the initiation of CRRT
Serum Ca2+
Serum total calcium concentration
Time frame: 2 hours after the initiation of CRRT
Effluent Ca2+
Effluent total calcium concentration
Time frame: 2 hours after the initiation of CRRT
Incidence of new-onset metabolic complications
Including hypercalcemia, hypocalcemia, metabolic acidosis, metabolic alkalosis, citrate accumulation, hypernatremia, and hyponatremia
Time frame: 48 hours after the initiation of CRRT
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