The CIRE Study (CItrate REcirculation Study) (CIRE)
Primary Purpose
Acute Kidney Injury
Status
Completed
Phase
Not Applicable
Locations
Belgium
Study Type
Interventional
Intervention
AV port reversal
Sponsored by
About this trial
This is an interventional treatment trial for Acute Kidney Injury
Eligibility Criteria
Inclusion Criteria:
- Critically ill patients requiring CRRT for AKI (RIFLE criteria)
- Written informed consent from the patient or legal representative
- No AV port reversal had taken place before inclusion in the study
- Diuresis is minimal or the patient is anuric so that effects of changes in clearance as a consequence of diuresis are minimalized and do not influence study outcomes.
- The patient has undergone CVVH for a number of days, ensuring good metabolic control, so that possible short term loss of clearance as a consequence of AV port reversal has no detrimental effects.
Exclusion Criteria:
- pre-existing chronic renal insufficiency requiring dialysis
- chronic immunosuppression
- liver cirrhosis Child-Pugh C
- severe or shock-related hepatitis
- Pregnancy
Sites / Locations
- Ziekenhuis Oost Limburg
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
AV port reversal
Arm Description
Patients undergoing citrate CVVH.
Outcomes
Primary Outcome Measures
change in citrate concentration in circuit after AV port reversal
change in post-filter ionised Ca after AV port reversal
change in clearance after AV port reversal
Secondary Outcome Measures
Full Information
NCT ID
NCT02600416
First Posted
October 15, 2015
Last Updated
March 28, 2018
Sponsor
Ziekenhuis Oost-Limburg
1. Study Identification
Unique Protocol Identification Number
NCT02600416
Brief Title
The CIRE Study (CItrate REcirculation Study)
Acronym
CIRE
Official Title
Effects of AV Port Reversal in Citrate CVVH - The CIRE Study (CItrate REcirculation Study)
Study Type
Interventional
2. Study Status
Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
December 2015 (undefined)
Primary Completion Date
September 1, 2017 (Actual)
Study Completion Date
September 1, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ziekenhuis Oost-Limburg
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The aim of this study is to determine the effects of AV port reversal (AVPR) on recirculation, clearance, post-filter ionized calcium and subsequently citrate dosing.
Detailed Description
Rationale:
AV port reversal (AVPR) has been demonstrated to increase recirculation in venous catheters used in ICU for CVVH. The effects of this frequently used manoeuvre have not been described in the setting of CVVH using regional citrate anticoagulation.
Objective:
The aim of this study is to determine the effects of AVPR on recirculation, clearance, post-filter ionized calcium and subsequently citrate dosing.
Study design and methods:
Open trial studying the effect of AVPR in patients undergoing citrate CVVH. After measurement in standard catheter configuration, AVPR is performed after which effects on catheter recirculation, clearance, citrate dosing and post-filter ionized calcium (iCa) are monitored.
Sample sites:
Arterial line, arterial (pre-filter) port, postfilter port (after postdilution and calcium compensation), effluent sample. All flow rates to be noted.
Study population:
Twelve patients admitted to intensive care, requiring continuous renal replacement therapy (CRRT) for AKI. Patients are preferably anuric and have achieved good metabolic control under CVVH before inclusion in the study.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Kidney Injury
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
24 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AV port reversal
Arm Type
Other
Arm Description
Patients undergoing citrate CVVH.
Intervention Type
Other
Intervention Name(s)
AV port reversal
Intervention Description
Reversal of the AV port at 1h Reversal of the AV port to start position at 7h
Primary Outcome Measure Information:
Title
change in citrate concentration in circuit after AV port reversal
Time Frame
8 hours
Title
change in post-filter ionised Ca after AV port reversal
Time Frame
8 hours
Title
change in clearance after AV port reversal
Time Frame
8 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Critically ill patients requiring CRRT for AKI (RIFLE criteria)
Written informed consent from the patient or legal representative
No AV port reversal had taken place before inclusion in the study
Diuresis is minimal or the patient is anuric so that effects of changes in clearance as a consequence of diuresis are minimalized and do not influence study outcomes.
The patient has undergone CVVH for a number of days, ensuring good metabolic control, so that possible short term loss of clearance as a consequence of AV port reversal has no detrimental effects.
Exclusion Criteria:
pre-existing chronic renal insufficiency requiring dialysis
chronic immunosuppression
liver cirrhosis Child-Pugh C
severe or shock-related hepatitis
Pregnancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Willem Boer, MD
Organizational Affiliation
Ziekenhuis Oost-Limburg
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ziekenhuis Oost Limburg
City
Genk
State/Province
Limburg
ZIP/Postal Code
3600
Country
Belgium
12. IPD Sharing Statement
Learn more about this trial
The CIRE Study (CItrate REcirculation Study)
We'll reach out to this number within 24 hrs