Comparing Continuous Veno-venous Hemodialysis and Hemodiafiltration for Urea Reduction in ICU Patients with Acute Kidney Injury

What this Trial Is About

Acute Kidney Injury AKI affects over half of patients in intensive care units ICUs, with many requiring renal replacement therapy RRT. This research compares two continuous RRT methods used in ICUs continuous venovenous hemodialysis CVVHD and continuous venovenous hemodiafiltration CVVHDF. The study aims to determine if CVVHD using citrate anticoagulation is as effective as CVVHDF with heparin in reducing urea levels and maintaining stable clearance, which could improve antibiotic management during treatment. Patients in the study will be randomly assigned to receive either CVVHD or CVVHDF. Both treatments use the same dialysis dose of 25 mlkgh and the same type of filter. CVVHD administration involves regional citrate anticoagulation, while CVVHDF uses systemic heparin anticoagulation. Treatments will be delivered using Fresenius Medical Care multiFiltrate PRO kits with Ultraflux AV1000S filters, ensuring consistency in equipment. Participants will be monitored closely with measurements including urea reduction rate at 24 hours as the main outcome. Additional evaluations include creatinine and urea clearance at 24 and 48 hours, mortality rates, organ failure-free days, electrolyte imbalances, and medical costs. The study involves adult ICU patients with AKI stage 3 undergoing their first RRT session, with follow-up continuing through ICU discharge and day 28. The trial is open-label and controlled to assess treatment efficiency and safety.

Continuous Veno-venous Hemodialysis and Continuous Veno-venous Hemodiafiltration on Urea Reduction Rate in Intensive Care Patient