CVVHD Dialysis parameters: Patients will receive a CVVHD dialysis with a dose of 25ml/kg/h dialysate (100% dialysate), with Fresenius Medical Care multiFiltrate PRO kit and Ultraflux AV1000S filter (polysuflone 1.8m²).Regional anticoagulation with citrate
CVVHDF Dialysis parameters: Patients will receive a CVVHDF dialysis with a dose of 25ml/kg/h dialysate (50% ultrafiltration, 50% dialysate), with Fresenius Medical Care multiFiltrate PRO kit and Ultraflux AV1000S filter (polysuflone 1.8m²). Systemic anticoagulation with heparine
Study 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
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
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 with PaCO₂ \< 35 mmHg or mixed acidosis with PaCO₂ \< 50 mmHg.
* Oliguria lasting 72 hours or longer
* Patients undergoing their first session of extracorporeal blood purification, initiated less than 12 hours prior to randomization
* 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
Primary outcome measure(s)
urea reduction rate (URR) — 24 hours The primary endpoint is the rate of urea reduction (TRU) at 24h as a percentage TRU H24 = (urea rate at H0 - urea rate at H24) / urea rate at H0 in each arm.
Trial sites (1)
Facility
City
Region
Status
CHU de Nimes
Nîmes
France
Recruiting
More Centre Hospitalier Universitaire de Nīmes trials in France
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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