Comparing Regional Citrate Anticoagulation and Calcium Reduction Without Citrate in Kidney Support Using Sustained Low-Efficiency Dialysis

What this Trial Is About

Researchers are studying anticoagulation methods for the extracorporeal circuit ECC used during Renal Replacement Therapy RRT in patients with acute kidney injury. The study compares two approaches regional citrate anticoagulation RCA, which uses citrate infusion to reduce ionized calcium and prevent clotting, and a citrate-free method that lowers ionized calcium through a calcium-free dialysate and hemofilter performance. This comparison aims to assess the efficiency and safety of avoiding citrate infusion, which can cause metabolic side effects. Participants will undergo intermittent RRT using Sustained Low-Efficiency Dialysis SLED with two treatment periods in a crossover design. One period involves regional anticoagulation using citrate-free decalcification, and the other uses regional citrate anticoagulation with 4% citrate infusion. The order of treatments is randomized, allowing each participant to receive both interventions sequentially. During each RRT session, researchers will measure plasma urea levels over 8 hours and monitor concentrations of ionized calcium and magnesium at specified intervals. Heart rate and blood pressure will be recorded frequently throughout the sessions. Additionally, occurrences of circuit losses and catheter thrombosis will be tracked. These evaluations help compare the anticoagulation methods effectiveness and safety over the study period, which concludes in November 2025.

Comparison of RCA and RACD in Extra-renal Purification by SLED