RecruitingNot ApplicableNCT05936710

Improved Hemodynamic Tolerance of Intermittent Hemodialysis Sessions in Intensive Care Unite Using Citrate- vs Acetate-based Dialysate

Improved Hemodynamic Tolerance of Intermittent Hemodialysis Sessions in Intensive Care Unite (ICU) Using Citrate- vs Acetate-based Dialysate

Sponsor

Centre Hospitalier de Bethune

Enrollment

48 participants

Start Date

Dec 7, 2023

Study Type

INTERVENTIONAL

Conditions

Intradialytic Hypotension

Summary

During intermittent hemodialysis (IHD), the occurrence of intradialytic hemodynamic instability (IHI) is frequent in ICU and impacted morbidity and mortality. Bicarbonate dialysate buffer improves hemodynamic tolerance compared to acetate dialysate buffer. However, bicarbonate dialysate buffer still contains a lower concentration of acetate, which could contribute to hemodynamic instability. Recently, citrate-based dialysate in bicarbonate hemodialysis instead of acetate have been proposed. They have the appropriate authorizations for routine use. The aim of this study is to compare acetate- vs citrate-based dialysate in terms of hemodynamic tolerance and effectiveness.

Eligibility

Min Age: 18 Years

Inclusion Criteria5

Patient ≥ 18 years old
Patient hospitalized in an intensive care unit
Patient with acute renal failure defined by a KDIGO stage ≥ 1 and suspected non-obstructive
Patient at risk of per dialytic hypotension (capillary refill time ≥ 3 seconds and/or cardiovascular SOFA ≥ 1 and/or lactatemia \> 2mmol/L)
Indication for Extra Renal Replacement Therapy with IHD.

Exclusion Criteria8

Pregnant or breastfeeding woman
Known chronic renal insufficiency of any stage
Cardio-renal and hepato renal syndrome
Unstable hemodynamic state: refractory shock
Patient included in another interventional study likely to modify the hemodynamic state
Patient deprived of liberty
Patient under guardianship or curatorship
Patient not affiliated to a social security system

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