Metabolic Complications Using a Low- Versus High Concentration Citrate Solution for Regional Anticoagulation in Continuous Kidney Replacement Therapy.

University Hospital, Antwerp176 enrolled

Overview

This study is a pragmatic, randomized trial comparing two commercially available citrate solutions to determine their impact on metabolic complications in critically ill patients with acute kidney injury receiving continuous kidney replacement therapy with regional citrate anticoagulation.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

176

Conditions

Acute Kidney Injury

Interventions

low concentrated citrate solution (18 mmol/L)DEVICE

use of a low concentrated citrate solution (18 mmol/L)

high concentrated citrate solution (136 mmol/L)DEVICE

high concentrated citrate solution (136 mmol/L)

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Any adult patient admitted to the intensive care unit with acute kidney injury requiring continuous kidney replacement therapy Exclusion Criteria: * expected duration of continuous kidney replacement therapy less than 96 hours * prior continuous kidney replacement therapy before inclusion * a known hypersensitivity to citrate, acute liver failure or liver cirrhosis Child-Pugh C * persistent severe hemodynamic shock with decreased lactate clearance * a high likelihood of dying within the first 24h after initiation of CKRT * preexisting severe electrolyte disorders before CKRT initiation not attributable to Acute kidney injury

Locations (1)

Antwerp University Hospital

Edegem, Antwerp, Belgium

Outcomes

Primary Outcomes

Need for additional electrolyte supplementation

Need for additional electrolyte supplementation : magnesium, phosphate, potassium expressed in grams of mmol during the 96 hour study period.

Time frame: 96 hours

Secondary Outcomes

Time course of serum electrolyte concentrations

Evolution of the serum electrolytes concentrations (potassium, magnesium, phosphorus, sodium, total calcium, ionized calcium, pH, bicarbonate) during the 96 hour study period for each arm.

Time frame: 96 hours

Incidence of electrolyte and acid-base disorders

Cumulative incidence of electrolyte and acid-base disorders (hyponatremia, hypernatremia, hypomagnesemia, hypophophatemia, hypokalemia, metabolic alkalosis, metabolic acidosis) in each arm during the 96 hour study period

Time frame: 96 hours

Data from ClinicalTrials.gov

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