Overview
The only supportive therapy for patients with AKI is renal replacement therapy (RRT). In the ICU setting, continuous RRT (CRRT) is mostly favored. In a post-hoc analysis of the RICH trial (regional citrate versus systemic heparin anticoagulation for CRRT in critically ill patient with AKI), it was shown that the filter life span is associated with an increased rate of new infection and that the type of anticoagulants did not directly affect infection rate. The mechanisms of this infection rate is unknown.
Description
Approximately every second patient in the ICU suffers from acute kidney injury (AKI) which complicates the clinical course of these patients. Continuous renal replacement therapy (CRRT) has become the most widely used form of renal support in critically ill patients as it allows continuous, controlled removal of fluids and is hemodynamically better tolerated compared to intermittent dialysis. The requirement for intravascular access and artificial circuits may increase the risk of infection. However, there are no studies analyzing the incidence and characteristics of infections in critically ill patients with CRRT or the implications for outcome. Therefore, this observational trial investigates the factors that influences new onset infection in critically ill patients with CRRT.
Eligibility
Inclusion Criteria:
- Adult patients (age ≥18 years)
- Critically ill patients with dialysis-dependent AKI
- Continuous renal replacement therapy (CRRT)
- Written informed consent
Exclusion Criteria:
- Chronic kidney disease with estimated glomerular filtration rate (eGFR)<30ml/min/1.73m2
- Chronic dialysis dependency
- Kidney transplant
- (Glomerulo-)nephritis, interstitial nephritis, vasculitis
- Patients on immunosuppression
- Patients with chronic inflammatory diseases (e.g. arthritis, HIV, chronic hepatitis)
- Persons with any kind of dependency on the investigator or employed by the sponsor or investigator