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Following the concept of "peak concentration hypothesis", which suggest the cutting peak of pro- and anti-inflammatory mediators would result in restoring a situation of immunohomeostasis. The investigators conducted the prospective randomized controlled trial aimed to compare the clearance efficacy between on-line hemodiafiltration and high-flux hemodialysis in sepsis-related acute kidney injury patients. The lowering cytokines level during sepsis is postulated to improved outcomes in sepsis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| On-line hemodiafiltration | Experimental | On-line hemodiafiltration is a type of renal replacement therapy that was assigned as the intervention to compare with the control arm |
|
| High-flux hemodialysis (control) | Active Comparator | The standard high-flux hemodialysis is the routine renal replacement therapy in sepsis-related acute kidney injury patients and is assigned as the intervention for the control group. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| On-line hemodiafiltration | Procedure | pre-dilution 40% of blood flow rate blood flow rate 300-350 ml/min dialysate flow rate 800 ml/min |
|
| Measure | Description | Time Frame |
|---|---|---|
| Reduction in plasma Vascular Endothelial Growth Factor (VEGF)level | At time 0-hour and 4-hour of the study dialysis session |
| Measure | Description | Time Frame |
|---|---|---|
| Intradialytic hypotension | During 4 hours of the study dialysis session | |
| Renal recovery (at 30 days) | participants will be followed for the renal recovery (dialysis-free) for the 30 days from the first initiation of dialysis |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Khajohn Tiranathanagul, M.D. | Chulalongkorn University | Principal Investigator |
| Wiwat Chancharoenthana, M.D. | Chulalongkorn University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| King Chulalongkorn Memorial Hospital | Bangkok | Bangkok | 10330 | Thailand |
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| ID | Term |
|---|---|
| D018805 | Sepsis |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D007239 | Infections |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
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| High-flux Hemodialysis | Procedure | blood flow rate 300-350 ml/min dialysate flow rate 800 ml/min |
|
| Hospital patient mortality | mortality during hospital admission | participants will be followed for the duration of hospital stay (an expected average of 5 weeks) |
| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |