Comparison of Sodium Levels in Dialysate for ICU Patients with Acute Kidney Injury Using Sustained Low Efficiency Dialysis-Filtration to Improve Hemodynamic Stability and Fluid Balance

What this Trial Is About

This research focuses on critically ill patients in the ICU who have acute kidney injury AKI and need renal replacement therapy RRT. It compares two sodium levels in dialysate used during sustained low efficiency daily dialysis-filtration SLEDD-f to see their effects on hemodynamic tolerance and fluid overload. The study aims to determine whether a lower sodium level 140 mmoll provides similar blood pressure stability during dialysis as a higher level 145 mmoll but with less fluid buildup, which is linked to worse outcomes in these patients. Patients in the ICU with AKI requiring RRT will be randomly assigned to receive SLEDD-f with dialysate sodium at either 140 or 145 mmoll. The dialysis is performed with set parameters including blood flow at 200 mlmin, dialysate flow at 200 mlmin, infusate flow at 60 mlmin, and temperature at 36C using a polysulfone membrane. Hemodynamic monitoring occurs during each dialysis session. The study is conducted at a single medical ICU and is not blinded to participants or staff. Participants will be closely monitored throughout their ICU stay, with daily assessments of weight, fluid input and output, and extracellular volume to track fluid overload. Researchers will evaluate hemodynamic tolerance during dialysis, fluid overload at 7 and 28 days after starting RRT, ultrafiltration rates, total duration of RRT, ICU length of stay, and mortality at 28 days. The study will last until December 2026 and is sponsored by the University Hospital of Montpellier.

Effects of Variation of Sodium Dialysate in ICU