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Amino Acid Loss During Continuous Renal Replacement Therapy

Recruiting
Conditions
Renal Insufficiency
Kidney Failure
Registration Number
NCT06659835
Lead Sponsor
Medical University of Vienna
Brief Summary

The goal of this observational study is to learn about amino acid loss during continuous renal replacement therapy and plasma amino acid levels in intensive care patients. The main questions it aims to answer are:

What amount of amino acids is lost over the duration of continuous renal replacement therapy? How do amino acid plasma concentrations change over time in patients with and without continuous renal replacement therapy?

Amino acid concentrations will be measured in the effluent and in the plasma of patients receiving continuous renal replacement therapy as part of their regular medical care. In addition, plasma concentrations of amino acids will be studied in patients without renal replacement therapy.

Detailed Description

In order to quantify the amount of amino acids lost via the continuous renal replacement (CRRT) machine, it is warranted to measure amino acid concentrations in the blood and effluent over the entire treatment period.

To this end, 20 intensive care patients will be examined throughout the entire duration of CRRT as part of this exploratory non-interventional study. Additionally, 10 intensive care patients without renal replacement therapy will be enrolled. In the CRRT-group amino acid loss through the effluent will be measured at different time points. Amino acid plasma concentrations will be determined in both groups. Amino acid urine concentration, nitrogen balance, as well as blood urea nitrogen, creatinine and albumin in the plasma will be measured as secondary outcome parameters. Additionally, observations regarding nutritional status and mobility (indirect calorimetry, bioimpedance analysis, ultrasound muscle and adipose tissue thickness, strength and mobility scoring) will be analyzed as exploratory secondary outcomes.

Duration of CRRT, length of intensive care and hospital stay as well as mortality will be monitored.

High-performance liquid chromatography fluorescence as well as liquid chromatography-mass spectrometry will be performed to measure amino acid concentrations in plasma, effluent and urine.

To answer the primary research question, change in amino acid plasma concentrations and effluent loss between treatment start and day 4 of continuous renal replacement therapy will be analysed using a two-sided Wilcoxon signed rank test.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Amino acid effluent lossCRRT start, day 4 of continuous renal replacement therapy

Change of effluent loss of amino acids from start of continuous renal replacement therapy to day 4

Amino acid plasma concentration CRRT groupday 0, day 4 of continuous renal replacement therapy

Change of plasma concentration of amino acids from start of continuous renal replacement therapy to day 4

Amino acid plasma concentration non-CRRT grouppreoperative day/enrollment to postoperative day 4

Change of plasma concentration of amino acids from the preoperative day to postoperative day 4 or to the last measurement at the intensive care unit, whichever is earlier

Secondary Outcome Measures
NameTimeMethod
Time course of effluent loss of amino acids over all measured time pointsduration of continuous renal replacement therapy, maximum 30 days

Time course of effluent loss of amino acids over all measured time points

Time course of plasma concentration of amino acids over all measured time pointspreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Time course of plasma concentration of amino acids over all measured time points

Urine concentration of amino acids over treatment periodpreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Urine concentration of amino acids over treatment period

Nitrogen balanceduration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Nitrogen balance over treatment period

Blood urea nitrogenpreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Blood urea nitrogen over treatment period

Creatininepreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Creatinine in blood, effluent, urine over treatment period

Albuminpreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Albumin in blood, effluent, urine over treatment period

Total proteinpreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Total protein in blood, effluent urine over treatment period

Vitaminsduration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Vitamins (Vitamin B12, folate) in blood, effluent, urine over treatment period

Trace elementsduration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Trace elements (iron, iodide) in blood, effluent, urine over treatment period

Indirect Calorimetryduration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Indirect calorimetry over treatment period

Bioimpedance analysispreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

Bioimpedance analysis over treatment period

Ultrasound Muscle and Adipose Tissue Thicknesspreoperative if recruited preoperatively, duration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

ultrasound to measure muscle and adipose tissue thickness over treatment period

Muscle Strengthduration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

muscle strength assessment (Medical Research Council Scale for Muscle Strength) over treatment period

Mobilityduration of continuous renal replacement therapy (CRRT group) or length of ICU stay (non CRRT-group), maximum 30 days

mobility assessment (Surgical Intensive Care Unit Optimal Mobilisation Score) over treatment period

Duration of Continuous Renal Replacement Therapyduration of Continuous Renal Replacement Therapy (CRRT group), through study completion on average 10 days

duration of Continuous Renal Replacement Therapy

Length of staylength of ICU and hospital stay, through study completion maximum 1 year

Length of ICU stay

Mortalitylength of ICU and hospital stay, through study completion maximum 1 year

mortality during ICU and hospital stay

Trial Locations

Locations (1)

Medical University of Vienna

🇦🇹

Vienna, Austria

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