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In the present prospective multicenter RCT we will evaluate the effects on efficacy, acid-base status and serum phosphate levels of a new RCA protocol for Continuous Venovenous Hemodiafiltration (CVVHDF) using an 18 mmol/l citrate solution in combination with a calcium-free phosphate-containing solution, acting as dialysate and replacement fluid. The new protocol will be introduced with the following targets: a) to refine buffers balance of a previously adopted RCA protocol for Continuous Venovenous Hemofiltration (CVVH), based on a 18 mmol/l citrate solution (Regiocit) combined with calcium and phosphate-free dialysate fluid (PrismOcal B22) and a conventional phosphate-containing replacement fluid (Phoxilium) to prevent CRRT-related phosphate depletion
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental Standard citrate protocol | Experimental | CVVHDF will be performed using Regiocit solution in the predilution mode, Biphozyl in the dialysate and postdilution mode. CRRT will be started at a dose of 35 ml/kg/h. |
|
| Conventionnal citrate protocol | Active Comparator | CVVHDF will be performed using Regiocit solution in the predilution mode, Prismocal B22 (calcium and phosphate free) in the dialysate mode, and Phoxilium in the postdilution mode. CRRT will be started at a dose of 35 ml/kg/h. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Biphozyl (dialysate and replacement) | Drug | Replacement solution with phosphate and without calcium in CRRT with citratre-based antigoagulation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Circuit lifetime | Number of minutes lifespan circuit | First 3 days of continous renal replacempent therapy |
| Measure | Description | Time Frame |
|---|---|---|
| Efficacy of the new RCA solution | Mean daily delivered RRT dose during the first 3 days of CRRT in ml/kg/h between two groups | first 3 days of CRRT |
| Efficacy of the new RCA solution | Percentage of decreasing urea during CRRT course between two groups |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lionel VELLY, MD/PhD | Contact | lionel.velly@ap-hm.fr |
| Name | Affiliation | Role |
|---|---|---|
| Emilie GARRIDO | Assistance Publique Hopitaux De Marseille | Study Director |
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| Prismocal B22 (dialysate) + phoxilium (replacement) | Drug | solution with phosphate and calcium in CRRT with citratre-based antigoagulation |
|
| first 3 days of CRRT |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| ID | Term |
|---|---|
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| D015314 | Dialysis Solutions |
| D012092 | Replantation |
| ID | Term |
|---|---|
| D019999 | Pharmaceutical Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
| D045506 | Therapeutic Uses |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D020313 | Specialty Uses of Chemicals |
| D014180 | Transplantation |
| D013514 | Surgical Procedures, Operative |
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