Acute Kidney Injury Severe COVID-19
Conditions
Interventions
After randomization, patients will be allocated to one of two groups:
Control group (n = 45): patients on continuous hemodialysis (blood flow 150 ml / min, dose of 30 ml / kg / h) receiving anticoagu
Intervention group (n = 45): patients on continuous hemodialysis (blood flow 150 ml / min, dose of 30 ml / kg / h) receiving anticoagulation with sodium citrate at 4 mmol / l associated with unfractio
Drug
E02.870.150
Sponsors
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
Eligibility
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: Men and women aged 18 and over; Confirmed or probable SARS-CoV-2 infection; Presence of acute kidney injury with indication and agreement between ICU and nephrology teams for the introduction of renal continuous venous venous hemodialysis.
Exclusion criteria
Exclusion criteria: Hypersensitivity to any of the substances used in the study (Citric acid dextrosol 2.2% and unfractionated heparin); Previous diagnosis of coagulopathy or thrombophilia; Contraindication to the use of unfractionated heparin by the assistant team; Risk of citrate poisoning - (Lactate> 30mg / dL, IRN> 2.5, Total bilirubin> 15mg / dL); Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The percentage of clotted dialyzers within 72 hours in each of the studied groups. Anticoagulation with citrate + heparin is expected to lead to a lower percentage of clotted dialyzers than anticoagulation with citrate alone, in 72 hours of therapy. | — |
Secondary
| Measure | Time frame |
|---|---|
| Expected outcome #1 Number of hours until a dialyzer clots in the first 72 hours of dialysis; Anticoagulation with citrate alone is expected to lead to dialyzer clotting earlier than in anticoagulation with citrate + heparin.;Expected outcome #2 Amount of dialyzers used in the first 72 hours of hemodialysis; It is expected that anticoagulation with citrate alone will lead to the need of a greater amount of dialyzers in 72 hours than in anticoagulation with citrate + heparin.;Expected outcome #3 Variation in dialysis system and vascular access pressures in the first 72 hours of hemodialysis; Anticoagulation with citrate alone is expected to lead to higher system and access pressures than with anticoagulation with citrate + heparin.;Expected outcome #4 Variation in the removal of urea (urea from the dialysate / blood urea) between the first, second and third days of dialysis; Anticoagulation with citrate + heparin is expected to lead to higher rates of urea removal, with less difference between therapy days, than anticoagulation with citrate alone.;Expected outcome #5 Downtime of dialysis due to clotting in the first 72 hours. Anticoagulation with citrate alone is expected to lead to longer downtime due to system clotting compared to anticoagulation with citrate + heparin. | — |
Countries
Brazil
Contacts
Public ContactCamila;Paulo Eleuterio Rodrigues;Gessolo Lins
Hospital das Clínicas da FMUSP;Hospital das Clínicas da FMUSP
Outcome results
None listed