Control Trial of Intermittent Hemodialysis With Regional Citrate VS Priming Heparin With Predilution in Patients at Risk of Bleeding

Randomized Controlled Trial of Intermittent Hemodialysis With Regional Citrate Anticoagulation Versus Systemic Low Dose Heparin Anticoagulation in Patients at Risk of Bleeding in Nephrology Intensive Care Unit

The study investigators hypothesize that intermittent hemodialysis with regional citrate anticoagulation (Prometheus system/Frésénius) is more efficient than reduced systemic heparin anticoagulation in patients at bleeding risk hospitalized in nephrology intensive care unit

Inclusion Criteria:

• The patient has been correctly informed.
• The patient must have given his/her informed and signed consent.
• The legal guardian or trusted-person of an adult under guardianship must have given their informed and signed consent.
• The patient has health insurance coverage via the French social security system.
• The patient is at least 18 years old.
• The patient is at bleeding risk; the bleeding risk is defined by the clinical situation and according to predefined clinical situations (before or after surgery or biopsy, hemorrhage).
• The patient requires an intermittent hemodialysis in a nephrology ICU setting.

Exclusion Criteria:

• The patient is participating in, or has participated in over the past three months, another interventional trial.
• The patient is in an exclusion period determined by a previous study.
• The patient is under judicial protection.
• The parents (or legal guardian) of the patient refuse to sign the consent.
• It is impossible to correctly inform the patient/parents (or legal guardian) of the patient (language barrier).
• Contraindication to heparin treatment.
• Indication of continuous dialysis in ICU.
• Pregnancy.