Please select the eligibility criteria that correspond to the clinical trial below.
Title: Impact of High-volume Veno-venous Continuous Hemofiltration in the Early Management of Septic Shock Patients With Acute Renal Failure
Brief Summary: Sepsis and septic shock are still important causes of mortality in intensive care medicine. Renal replacement therapy by standard volume haemofiltration is currently used, but a higher-volume haemofiltration may improve the prognosis. The study is a prospective randomized multicenter trial comparing two treatments in patients suffering from septic shock complicated with acute renal failure admitted to ICU. One group will be treated by early high volume haemofiltration (70 ml/kg/h) and the second group by standard volume haemofiltration (35 ml/kg/h). The main outcome will be one-month mortality.


Options:
A: Inclusion Criteria:

* Acute renal failure clinically consistent with a diagnosis of acute tubular necrosis
* Plan for renal replacement therapy by clinical team
* Receiving care in a critical care unit
* One non-renal organ failure or sepsis
* Age 18 or older
* Patient or surrogate provides informed consent

Exclusion Criteria:

* Baseline serum creatinine \> 2 mg/dL (177 mol/L) in males, \> 1.5 mg/dL (133 mol/L) in females
* Acute renal failure clinically believed to be due to an etiology other than acute tubular necrosis
* More than 72 hours since meeting both of the following conditions:

  1. Fulfillment of the definition of ARF; and
  2. BUN \> 100 mg/dL (36 mmol/L)
* More than 1 hemodialysis treatment or more than 24 hours since starting continuous renal replacement therapy
* Prior kidney transplant
* Pregnancy
* Prisoner
* Weight \> 128.5 kg
* Non-candidacy for renal replacement therapy
* Moribund state
* Patient not expected to survive 28 days because of underlying terminal chronic medical condition
* Comfort-measures-only status
* Participation in a concurrent interventional study
* Patient/surrogate refusal
* Physician refusal
B: Inclusion Criteria:

* septic shock (Bone criteria) for less than 24 hours
* RIFLE criteria : injury or worse
* age over 18 years
* written informed consent by next of kin.

Exclusion Criteria:

* cirrhosis
* age over 80 years
* life expectancy less than 3 months or metastatic cancer
* for women : pregnancy and breastfeeding
C: Inclusion Criteria:

1. The treating clinician believes that the patient requires CRRT for acute renal failure.
2. The clinician is uncertain about the balance of benefits and risks likely to be conferred by treatment with higher intensity or lower intensity CRRT.
3. The treating clinicians anticipate treating the patient with CRRT for at least 72 hours.
4. Informed consent has been obtained
5. The patient fulfils ONE of the following clinical criteria for initiating CRRT:

   * Oliguria (urine output \< 100ml/6hr) that has been unresponsive to fluid resuscitation measures.
   * Hyperkalemia (\[K+\] \> 6.5 mmol/L).
   * Severe acidemia (pH \< 7.2).
   * Urea \> 25 mmol/liter.
   * Creatinine \>300 micromol/L in the setting of ARF.
   * Clinically significant organ oedema in the setting of ARF (eg: lung).

Exclusion Criteria:

1. Patient age is \<18 years.
2. Death is imminent (\<24 hours).
3. There is a strong likelihood that the study treatment would not be continued in accordance with the study protocol.
4. The patient has been treated with CRRT or other dialysis previously during the same hospital admission.
5. The patient was on maintenance dialysis prior to the current hospitalisation.
6. The patient's body weight is \<60 kg or \>100kg.
7. Any other major illness that, in the investigator's judgment, will substantially increase the risk associated with the subject's participation in this study.
D: Inclusion Criteria:

1. Cardiac surgery with cardiopulmonary bypass
2. Patient still on high doses catecholamines 3 to 24 hours following cardiac-surgical ICU admission. High doses catecholamines is defined by IV infusion of :

   1. Epinephrine \>0.2 microg/kg/min or
   2. Norepinephrine \>0.4 microg/kg/min or
   3. Epinephrine + (Norepinephrine /2) \>0.2 microg/kg/min
   4. Cardiac assistance using ECMO/ECLS technique are considered equivalent to high doses catecholamines.
3. Informed consent has been obtained from next of kin or when consent cannot be obtained, the intervention is randomized, and written informed consent obtained from the patient as soon as he regains consciousness. This practice is consistent with the French law for clinical research.

Exclusion Criteria:

1. Age \< 18 years
2. Pregnancy
3. Chronic hemodialysis prior to heart surgery
4. Body weight \>120 kg
5. Moribund state, defined as SAPS 2 score\> 90
6. Severe underlying disease with survival expectancy of less than 8 days
7. Decision to withhold or withdraw active therapeutics
8. PrismaFlex machine unavailable in the unit
9. Intravascular access with dialysis catheter impossible -

Answer: B