Citrate pharmacokinetics in acute liver failure clinically ill patients receiving continuous renal replacement therapy

Citrate pharmacokinetics in critically ill liver failure patients receiving CRRT

Status

Active, not recruiting

Phases

Phase 2Phase 3

Study type

Interventional

Source

TCTR

Registry ID

TCTR20210707010

Enrollment

Registered

2021-07-07

Start date

2019-07-01

Completion date

Unknown

Last updated

2026-08-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Citrate Toxicity Regional Citrate Anticoagulation Liver Failure, Acute Liver Failure, Acute on Chronic Pharmacokinetic Continuous Renal Replacement Therapy Regional citrate anticoagulation Liver failure Pharmacokinetics CRRT Cirrhosis

Interventions

A pharmacokinetic study by start CRRT with continuous venovenous hemofiltration mode. We prescribed isotonic citrate solution (13.3 mmol/L) as predilution, targeting citrate dose at 3 mmol/L for 2 hou

Experimental Drug,Experimental Drug

Acute liver failure arm,Acute on top chronic liver failure arm

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Inclusion criteria

Inclusion criteria: 1. critically ill ALF or ACLF adult patients with AKI, 2. aged more than 18 y old, 3. receiving CRRT

Exclusion criteria

Exclusion criteria: 1. severe acidosis (pH < 7.1) or severe alkalosis (pH > 7.55), 2. blood transfusion within 24 h prior to the study, 3. use of citrate-containing medications, 4. severe hypocalcemia (serum ionized calcium < 0.8 mmol/L), 5. use of heparin as anticoagulation.

Design outcomes

Primary

Measure	Time frame
Citrate clearance 4 hours Pharmacokinetic study	—

Secondary

Measure	Time frame
Citrate accumulation 4 hours Number of total calcium to ionized calcium ratio more than 2.5 with acidosis with hypocalcemia,Time max 2 hours Time to maximum concentration of citrate at 2 hours,Area under the time curve 4 hours Area under the plasma concentration-time curve of citrate,Change of systemic ionized calcium 4 hours Change in systemic ionized calcium in arterial blood gas during study,Change of ionized magnesium 4 hours Change of ionized magnesium,Change of bicarbonate 4 hours Change of bicarbonate in arterial blood gas during study,Ratio of total calcium to systemic ionized calcium 4 hours Ratio of total calcium to systemic ionized calcium	—

Measure

Time frame

Citrate accumulation 4 hours Number of total calcium to ionized calcium ratio more than 2.5 with acidosis with hypocalcemia,Time max 2 hours Time to maximum concentration of citrate at 2 hours,Area under the time curve 4 hours Area under the plasma concentration-time curve of citrate,Change of systemic ionized calcium 4 hours Change in systemic ionized calcium in arterial blood gas during study,Change of ionized magnesium 4 hours Change of ionized magnesium,Change of bicarbonate 4 hours Change of bicarbonate in arterial blood gas during study,Ratio of total calcium to systemic ionized calcium 4 hours Ratio of total calcium to systemic ionized calcium

—

Countries

Thailand

Contacts

Public ContactNattachai Srisawat

King Chulalongkorn Memorial Hospital

drnattachai@yahoo.com6622564000

Outcome results

None listed

Source: TCTR (via WHO ICTRP) · Data processed: Aug 9, 2026