Elimination of Antibiotics During Citrate-anticoagulated Continuous-veno-venous-haemodialysis

Elimination of Antibiotics During Citrate-anticoagulated Continuous-veno-venous-haemodialysis

Acute kidney injury (AKI) requiring renal replacement therapy is common in critically ill patients. The major causes of AKI are severe sepsis and septic shock requiring effective antibiotic treatment. Patients with sepsis on ICUs usually are haemodynamically instable so that renal replacement therapy is applied using continuous techniques. In recent years, the efficacy of renal replacement therapies has improved, namely by using regional citrate anticoagulation which improves filter lifetime and filter patency. At present, the extent of removal of antibiotic drugs using citrate-anticoagulated CVVHD in critically ill patients has not been investigated thoroughly. Thus, the investigators want to investigate

1. whether and to what extent antibiotic drugs (piperacillin/tazobactam and imipenem/cilastatin) are removed during citrate-anticoagulated CVVHD per se
2. whether filter patency during citrate-anticoagulated CVVD remains stable during a treatment period of 72 h

Inclusion Criteria:

• Intensive care patients with acute kidney injury requiring continous renal replacement therapy with citrate-anticoagulation
• Age > 18 y

Exclusion Criteria:

• < 18 y
• Pregnancy
• Contraindications against citrate-anticoagulation or continous renal replacement therapy