Dialysis
Conditions
Brief summary
Citrate anticoagulation is becoming the gold standard in dialysis in intensive care units. It is now accepted that citrate prolongs the life of filters with a lower risk of bleeding. However, the management of citrate is complex. Optimization is based on citrate flow, blood flow and the amount of calcium reinjected. Frequently the citrate level is sub-dosed.Currently, the fraction of excretion of citrate by the hemodialysis machine is unknown. Knowing this information would allow, if it is important enough, to add an additional parameter of citrate management by adapting the level of dialysis. The determination of citrate in an extracorporeal circulation circuit has already been performed and has been validated in the literature. We propose to perform the assay on subjects with the same starting parameters, in order to deduce the clearance of citrate.
Interventions
DIAGNOSTIC_TESTCitrate dosage
Patients are dialysed according to the standard of care. Biological variables are measured in pre-filter, post-filter and dialysate 30 minutes after the dialysis is initiated.
Sponsors
Dr David DE BELS
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- Intensive care dialysis patients (Continuous Venous Hemofiltration with citrate).
Exclusion criteria
\- None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Citrate concentration - pre-filter | 30 minutes after the start of dialysis | Citrate concentration in a blood sample taken before the dialysis filter |
| Citrate concentration - post-filter | 30 minutes after the start of dialysis | Citrate concentration in a blood sample taken after the dialysis filter |
| Citrate concentration - dialysate | 30 minutes after the start of dialysis | Citrate concentration in a blood sample taken in the dialysate |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Age | Baseline | Age |
| Apache II score | Baseline | The APACHE II score is calculated at the beginning of the intensive care unit admission to help determine the patient's mortality risk for the admission. An integer score from 0 to 71 is computed based on several measurements; higher scores correspond to more severe disease and a higher risk of death. |
| SOFA (Sequential Organ Failure Assessment) score | Baseline | The Sequential Organ Failure Assessment score (SOFA score), is used in intensive care units to determine and track the status of a patient with organ failure. The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems. Higher scores mean a higher risk of mortality. |
| Glomerular filtration rate (GFR) | Baseline | Glomerular filtration rate |
| Creatinin level | Baseline | Creatinin level |
| Diuresis | Baseline | Volume of urinary secretion in the last 12 hours |
| KDIGO classification | Baseline | The KDIGO classification defines 3 stages of increasing severity for acute kidney injuries. |
| Na (sodium) concentration -pre-filter | 30 minutes after the start of dialysis | Na (sodium) concentration in a blood sample taken before the dialysis filter |
| Na (sodium) concentration -post-filter | 30 minutes after the start of dialysis | Na (sodium) concentration in a blood sample taken after the dialysis filter |
| Cl (chlorine) concentration - pre-filter | 30 minutes after the start of dialysis | Cl (chlorine) concentration in a blood sample taken before the dialysis filter |
| Cl (chlorine) concentration -post-filter | 30 minutes after the start of dialysis | Cl (chlorine) concentration in a blood sample taken after the dialysis filter |
| K (potassium) concentration - pre-filter | 30 minutes after the start of dialysis | K (potassium) concentration in a blood sample taken before the dialysis filter |
| K (potassium) concentration - post-filter | 30 minutes after the start of dialysis | K (potassium) concentration in a blood sample taken after the dialysis filter |
| Total Ca (calcium) concentration -pre-filter | 30 minutes after the start of dialysis | Ca (calcium) concentration in a blood sample taken before the dialysis filter |
| Total Ca (calcium) concentration -post-filter | 30 minutes after the start of dialysis | Ca (calcium) concentration in a blood sample taken after the dialysis filter |
| Total Ca (calcium) concentration -dialysate | 30 minutes after the start of dialysis | Ca (calcium) concentration in the dialysate |
| Ionized calcium (Ca2+) concentration -pre-filter | 30 minutes after the start of dialysis | Ca (calcium) concentration in a blood sample taken before the dialysis filter |
| Ionized calcium (Ca2+) concentration -post-filter | 30 minutes after the start of dialysis | Ca (calcium) concentration in a blood sample taken after the dialysis filter |
| Ionized calcium (Ca2+) concentration -dialysate | 30 minutes after the start of dialysis | Ca (calcium) concentration in the dialysate |
| Mg (magnesium) concentration - pre-filter | 30 minutes after the start of dialysis | Mg (magnesium) concentration in a blood sample taken before the dialysis filter |
| Mg (magnesium) concentration - post-filter | 30 minutes after the start of dialysis | Mg (magnesium) concentration in a blood sample taken after the dialysis filter |
| PO4 (phosphate) concentration - pre-filter | 30 minutes after the start of dialysis | PO4 (phosphate) concentration in a blood sample taken before the dialysis filter |
| PO4 (phosphate) concentration - post-filter | 30 minutes after the start of dialysis | PO4 (phosphate) concentration in a blood sample taken after the dialysis filter |
| Lactate concentration - pre-filter | 30 minutes after the start of dialysis | Lactate blood concentration in a blood sample taken before the dialysis filter |
| Lactate concentration - post-filter | 30 minutes after the start of dialysis | Lactate blood concentration in a blood sample taken after the dialysis filter |
| Albumin concentration -pre-filter | 30 minutes after the start of dialysis | Albumin concentration in a blood sample taken before the dialysis filter |
| Albumin concentration -post-filter | 30 minutes after the start of dialysis | Albumin concentration in a blood sample taken after the dialysis filter |
| pH - pre-filter | 30 minutes after the start of dialysis | pH of a blood sample taken before the dialysis filter |
| pH - post-filter | 30 minutes after the start of dialysis | pH of a blood sample taken after the dialysis filter |
| Total C-reactive protein (CRP) -pre-filter | 30 minutes after the start of dialysis | Total CRP concentration in a blood sample taken before the dialysis filter |
| Total C-reactive protein (CRP) -post-filter | 30 minutes after the start of dialysis | Total CRP concentration in a blood sample taken after the dialysis filter |
| Total C-reactive protein (CRP) -dialysate | 30 minutes after the start of dialysis | Total CRP concentration in a blood sample taken in the dialysate |
| Weight | Baseline | Weight |
| Monomeric C-reactive protein (CRP) -post-filter | 30 minutes after the start of dialysis | Monomeric CRP concentration in a blood sample taken after the dialysis filter |
| Monomeric C-reactive protein (CRP) -dialysate | 30 minutes after the start of dialysis | Monomeric CRP concentration in a blood sample taken in the dialysate |
| Monomeric C-reactive protein (CRP) -pre-filter | 30 minutes after the start of dialysis | Monomeric CRP concentration in a blood sample taken before the dialysis filter |
| Height | Baseline | Height |
| Sex | Baseline | Sex |
Countries
Belgium
Contacts
Primary ContactSébastien Redant, MD
Outcome results
None listed