Determination of Citrate Clearance Used in Regional Anticoagulation of Continuous Venous Hemofiltration Circuits
- Conditions
- Dialysis
- Interventions
- Diagnostic Test: Citrate dosage
- Registration Number
- NCT04024007
- Lead Sponsor
- Dr David DE BELS
- Brief Summary
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.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 100
- Intensive care dialysis patients (Continuous Venous Hemofiltration with citrate).
- None
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Dialysis patients Citrate dosage Intensive care dialysis patients (Continuous Venous Hemofiltration with citrate). Dialysis performed according to the standard indications of the service. Patients are dialysed with the prismaflex system on AN69ST membranes.
- Primary Outcome Measures
Name Time Method Citrate concentration - pre-filter 30 minutes after the start of dialysis Citrate concentration in a blood sample taken before the dialysis filter
Citrate concentration - post-filter 30 minutes after the start of dialysis Citrate concentration in a blood sample taken after the dialysis filter
Citrate concentration - dialysate 30 minutes after the start of dialysis Citrate concentration in a blood sample taken in the dialysate
- Secondary Outcome Measures
Name Time Method Weight Baseline Weight
Height Baseline Height
Sex Baseline Sex
PO4 (phosphate) concentration - pre-filter 30 minutes after the start of dialysis PO4 (phosphate) concentration in a blood sample taken before the dialysis filter
Age Baseline Age
PO4 (phosphate) concentration - post-filter 30 minutes after the start of dialysis PO4 (phosphate) concentration in a blood sample taken after the dialysis filter
Apache II score Baseline 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.
SOFA (Sequential Organ Failure Assessment) score Baseline 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.
Glomerular filtration rate (GFR) Baseline Glomerular filtration rate
Creatinin level Baseline Creatinin level
Diuresis Baseline Volume of urinary secretion in the last 12 hours
KDIGO classification Baseline The KDIGO classification defines 3 stages of increasing severity for acute kidney injuries.
Na (sodium) concentration -pre-filter 30 minutes after the start of dialysis Na (sodium) concentration in a blood sample taken before the dialysis filter
Na (sodium) concentration -post-filter 30 minutes after the start of dialysis Na (sodium) concentration in a blood sample taken after the dialysis filter
Cl (chlorine) concentration - pre-filter 30 minutes after the start of dialysis Cl (chlorine) concentration in a blood sample taken before the dialysis filter
Cl (chlorine) concentration -post-filter 30 minutes after the start of dialysis Cl (chlorine) concentration in a blood sample taken after the dialysis filter
K (potassium) concentration - pre-filter 30 minutes after the start of dialysis K (potassium) concentration in a blood sample taken before the dialysis filter
K (potassium) concentration - post-filter 30 minutes after the start of dialysis K (potassium) concentration in a blood sample taken after the dialysis filter
Total Ca (calcium) concentration -pre-filter 30 minutes after the start of dialysis Ca (calcium) concentration in a blood sample taken before the dialysis filter
Total Ca (calcium) concentration -post-filter 30 minutes after the start of dialysis Ca (calcium) concentration in a blood sample taken after the dialysis filter
Total Ca (calcium) concentration -dialysate 30 minutes after the start of dialysis Ca (calcium) concentration in the dialysate
Ionized calcium (Ca2+) concentration -pre-filter 30 minutes after the start of dialysis Ca (calcium) concentration in a blood sample taken before the dialysis filter
Ionized calcium (Ca2+) concentration -post-filter 30 minutes after the start of dialysis Ca (calcium) concentration in a blood sample taken after the dialysis filter
Ionized calcium (Ca2+) concentration -dialysate 30 minutes after the start of dialysis Ca (calcium) concentration in the dialysate
Mg (magnesium) concentration - pre-filter 30 minutes after the start of dialysis Mg (magnesium) concentration in a blood sample taken before the dialysis filter
Mg (magnesium) concentration - post-filter 30 minutes after the start of dialysis Mg (magnesium) concentration in a blood sample taken after the dialysis filter
Lactate concentration - pre-filter 30 minutes after the start of dialysis Lactate blood concentration in a blood sample taken before the dialysis filter
Lactate concentration - post-filter 30 minutes after the start of dialysis Lactate blood concentration in a blood sample taken after the dialysis filter
Albumin concentration -pre-filter 30 minutes after the start of dialysis Albumin concentration in a blood sample taken before the dialysis filter
Albumin concentration -post-filter 30 minutes after the start of dialysis Albumin concentration in a blood sample taken after the dialysis filter
pH - pre-filter 30 minutes after the start of dialysis pH of a blood sample taken before the dialysis filter
pH - post-filter 30 minutes after the start of dialysis pH of a blood sample taken after the dialysis filter
Total C-reactive protein (CRP) -pre-filter 30 minutes after the start of dialysis Total CRP concentration in a blood sample taken before the dialysis filter
Total C-reactive protein (CRP) -post-filter 30 minutes after the start of dialysis Total CRP concentration in a blood sample taken after the dialysis filter
Total C-reactive protein (CRP) -dialysate 30 minutes after the start of dialysis Total CRP concentration in a blood sample taken in the dialysate
Monomeric C-reactive protein (CRP) -pre-filter 30 minutes after the start of dialysis Monomeric CRP concentration in a blood sample taken before the dialysis filter
Monomeric C-reactive protein (CRP) -post-filter 30 minutes after the start of dialysis Monomeric CRP concentration in a blood sample taken after the dialysis filter
Monomeric C-reactive protein (CRP) -dialysate 30 minutes after the start of dialysis Monomeric CRP concentration in a blood sample taken in the dialysate
Trial Locations
- Locations (1)
CHU Brugmann
🇧🇪Brussels, Belgium