Continuous Veno-venous Hemodialysis and Continuous Veno-venous Hemodiafiltration on Urea Reduction Rate in Intensive Care Patient
Trial Parameters
Brief Summary
In patients requiring renal replacement therapy (RRT) in the intensive care unit (ICU), continuous techniques are predominantly using due to better hemodynamic tolerance. The most employed techniques in ICU are continuous venovenous hemodiafiltration (CVVHDF) and continuous venovenous hemodialysis (CVVHD). To our knowledge, there are no prospective studies comparing the efficiency of these two techniques with the same dose of dialysis (and the same filter). In the CompEER study, we aim to compare the efficiency of CVVHD and CVVHDF on urea reduction rate in intensive care patients with acute kidney injury. The research hypothesis is that CVVHD citrate technique is as effective as CVVHDF heparin technique for urea reduction and provides prolonged and stable clearance, facilitating antibiotic management during RRT.
Eligibility Criteria
Inclusion criteria: * Adult patients hospitalized in ICU * Undergo RRT session because of AKI stage 3 * At least one among criteria: pH \< 7,20 / Blood urea \> 30mM / Fluid overload uncontrolled by diuretics. * Patient having given free and informed consent, and having signed the consent form or patient included in an emergency situation * Patient affiliated with Social Security. Exclusion criteria: * End-stage chronic kidney disease on dialysis * Intoxication with a dialyzable toxin (lithium * Criteria for emergency dialysis initiation: hyperkaliemia \>6,5mM with electrocardiographic signs * Medical contraindication to regional citrate: severe liver failure * Medical contraindication to anticoagulation or heparin anticoagulation: heparin induced thrombopenia or uncontrolled bleeding * Pregnant women, parturient or breast-feeding patient