Health Condition 1: K746- Other and unspecified cirrhosis ofliver
Conditions
Interventions
Intervention1: Sustained Low Efficiency Dialysis: Sustained Low Efficiency Dialysis until renal recovery.
Control Intervention1: Continuous Renal Replacement Therapy: Continuous Renal Replacement Ther
Sponsors
Institute of Liver and Biliary Sciences
Eligibility
Inclusion criteria
Inclusion criteria: Critically ill cirrhotics with septic shock defined as need of vasopressors to maintain MAP > 65 mm Hg and lacate >2 mmol/L despite adequate fluid resuscitation with severe AKI meeting criteria for dialysis
Exclusion criteria
Exclusion criteria: 1. Patients with age less than 18 years or more than 65 years 2. Severe known cardiopulmonary disease (structural or valvular heart disease, coronary artery disease, COPD, CKD) 3. Patients with ACLF 4. Patients with cerebral edema 5. Patients with refractory shock i.e. requiring norepinephrine or equivalent >0.5ug/kg/min 6. Severe coagulopathy platelets 4 7. Active Bleed (Mucosal or variceal) 8. Pregnancy 9. Patients with moderate-severe ARDS i.e. Pa02/Fio2 ratio 10. Extremely moribund patients with an expected life expectancy of less than 24 hours 11. Failure to give informed consent from family members. 12. Patient enrolled in other clinical trials 13. Patients with Hepatorenal Syndrome, post renal obstructive AKI, AKI suspected due to glomerulonephritis, interstitial nephritis or vasculitis based on clinical history and urine analysis 14. Patients who have already been on hemodialysis before their arrival in the intensive care unit 15. Patients with severe vasodilatation SVR > 5 mmol/L
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Development of intradialytic hypotension i.e. decrease in defined as a decrease in systolic blood pressure by â?¥20 mm Hg or a decrease in MAP by 10 mm Hg after initiation of dialysisTimepoint: at 6 hours after dialysis initiation | — |
Secondary
| Measure | Time frame |
|---|---|
| AKI recovery at day 14Timepoint: Day 14;Duration of mechanical ventilation and ICU stayTimepoint: Day 28;Lactate clearance at 12 hrs and 24 hoursTimepoint: 12 hrs and 24 hours;MortalityTimepoint: 28 days;Renal failure related death at day 7Timepoint: Day 7;Reversal of shock at 48 hoursTimepoint: 48 hours | — |
Countries
India
Contacts
Public ContactDr Rakhi Maiwall
Institute of Liver and Biliary Sciences
Outcome results
None listed