Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Citrate-based Regional Anticoagulation Versus Heparin for Continuous Renal Replacement Therapy in Critically Ill Patients With Acute Renal Failure: a Randomized Controlled Trial
Brief Summary: Critically ill patients with acute kidney injury (AKI) are at high risk of bleeding on account of coagulopathy, platelet dysfunction, frequent liver dysfunction and invasive procedures.In patients at high risk of bleeding, anticoagulation restricted to the circuit (regional anticoagulation) has been advocated as the method of choice.However, citrate anticoagulation may have many metabolic consequences, such as metabolic alkalosis due to citrate metabolism into bicarbonate, and in patients with liver disease, metabolic acidosis and hypocalcemia may occur.Implementation of citrate-based regional anticoagulation with frequent monitoring of acid-base and electolytes is also more challenging for the nurses and does not eliminate the need of a low-dose systemic anticoagulation for thromboses prophylaxis in most of the patients. Citrate-based regional anticoagulation is therefore mainly advocated only for patients at high-risk of bleeding.

The investigators plan to implement an open-label randomized control trial assessing the effectiveness of citrate-based regional anticoagulation in critically ill patients with AKI and with a special emphasis on the safety profile of this treatment in patients with severe liver failure.


Options:
A: Arm Label: heparin; Type: PLACEBO_COMPARATOR; Interventions: Device: citrate regional anticoagulation | Arm Label: citrate regional anticoagulation; Type: ACTIVE_COMPARATOR; Interventions: Device: citrate regional anticoagulation | Intervention Type: DEVICE; Name: citrate regional anticoagulation; Assigned to Arm(s): heparin | Intervention Type: DEVICE; Name: citrate regional anticoagulation; Assigned to Arm(s): citrate regional anticoagulation, heparin
B: Arm Label: CVVH arm; Type: ACTIVE_COMPARATOR; Interventions: Other: RRT for acute kidney failure using the CVVH method | Arm Label: IHD arm; Type: ACTIVE_COMPARATOR; Interventions: Other: RRT for acute kidney failure using the IHD (intermittent HD) | Intervention Type: OTHER; Name: RRT for acute kidney failure using the CVVH method; Assigned to Arm(s): CVVH arm | Intervention Type: OTHER; Name: RRT for acute kidney failure using the IHD (intermittent HD); Assigned to Arm(s): IHD arm
C: Arm Label: Dilute heparin; Type: ACTIVE_COMPARATOR; Interventions: Drug: Dilute unfractionated heparin | Arm Label: Standard concentrated heparin; Type: ACTIVE_COMPARATOR; Interventions: Drug: Standard concentration unfractionated heparin | Intervention Type: DRUG; Name: Dilute unfractionated heparin; Assigned to Arm(s): Dilute heparin | Intervention Type: DRUG; Name: Standard concentration unfractionated heparin; Assigned to Arm(s): Standard concentrated heparin
D: Arm Label: M100; Type: ACTIVE_COMPARATOR; Interventions: Drug: Anticoagulation with nafamostat mesilate | Arm Label: HF1000; Type: EXPERIMENTAL; Interventions: Drug: Anticoagulation with nafamostat mesilate | Intervention Type: DRUG; Name: Anticoagulation with nafamostat mesilate; Assigned to Arm(s): HF1000, M100

Answer: A