Patients who need CRRT and are at high risk for bleeding
Conditions
Interventions
RAC group:4% regional citrate anticoagulation
NM group: Nafamostat Mesilate( NM)
Sponsors
Department of Nephrology, the First Affiliated Hospital, the Air Force Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1) Age =18 years old 2) CRRT treatment: (1) unmanageable volume overload associated with organ edema or drug overdoses and toxins that can be cleared by dialysis; (2) Uncorrectable acidosis (metabolic or mixed acidosis, blood pH 6.5 mmol/L; Blood sodium > 160mmol/L or blood sodium 30 mmol/L),6, others 3) High-risk bleeding patients: PLT 60 s, INR > 2.0, bleeding or active bleeding within 7 days, recent trauma or surgical procedures (especially head trauma and neurosurgery), recent stroke, intracranial venous malformations or aneurysms, retinal bleeding, uncontrolled hypertension, There's an epidural catheter implanted 4) Agree to join the study
Exclusion criteria
Exclusion criteria: 1) Patients with previous regular hemodialysis and peritoneal dialysis 2) Patients who are receiving systemic anticoagulation (heparin/low molecular weight/warfarin, etc.) and do not require additional anticoagulant use 3) Shock combined with tissue hypoperfusion: ? persistent hypotension(systolic blood pressure 40 mmHg); ? Serum lactic acid >4mmol/L; ? On the basis of sufficient replenishment of blood volume, it is still necessary to use pressor drugs to maintain the mean arterial pressure >65mmHg 4) Severe liver failure: Child-Pugh score > 10 (chronic severe liver failure), MELD score > 30 (acute severe liver failure), total bilirubin > 51µmol/L 5) Patients who are pregnant or breastfeeding 6)HIV infection 7) Contraindications to the use of sodium citrate or napalmostat mesylate (allergies, history of prior drug accumulation)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of filter failure; | — |
Secondary
| Measure | Time frame |
|---|---|
| 28 day mortality rate; | — |
Countries
China
Contacts
Public ContactMingbai
Department of Nephrology, Xijing Hospital, The Fourth Military Medical University
Outcome results
None listed