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

Centre Hospitalier de Bethune

Status: Enrolling

Conditions: Intradialytic Hypotension

Treatments: Device: ACETATE based dialysate; Device: CITRATE based dialysate

Study type: Interventional

Funder types: NETWORK; Other

Identifiers

NCT05936710

2023-01

Details and patient eligibility

About

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.

Enrollment: 48 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 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 criteria

• 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

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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48 participants in 2 patient groups

Control group

Other group

Description:

Using acetate-based dialysate

Treatment:

Device: ACETATE based dialysate

Experimental group

Experimental group

Description:

Using citrate-based dialysate

Treatment:

Device: CITRATE based dialysate