Parathyroid Hormone Kinetics During CRRT

Study Overview
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Brief Summary
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The objective of this study is to assess the parathyroid hormone serum concentrations and kinetics in critically ill patients admitted to the intensive care unit due to multi-organ failure and undergoing citrate anticoagulation continuous renal replacement therapy.

Official Title
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Trends in Parathyroid Hormone Plasma Concentration in Multi-organ Failure Critically Ill Patients Undergoing Regional Citrate Anticoagulation Continuous Renal Replacement Therapies - Prospective Observational Study.

Conditions
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Critical Illness, Multi Organ Failure, Renal Failure, Circulatory Failure, Respiratory Failure

Intervention / Treatment
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* Diagnostic Test: parathyroid hormone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute respiratory failure Acute circulatory failure acute kidney injury treated with regional citrate anticoagulation continuous renal replacement therapy by means of continuous veno-venous hemodiafiltration (CVVHDF continuous renal replacement therapy started no later than 48 hours after admission SOFA score 5 or more Exclusion Criteria: age less than 18 years acute liver failure hypercalcemia at admission (total calcium plasma level > 10.6 mg/dL; total ionized calcium plasma level > 1.35 mmol/L parathyroid glands disease end stage renal disease therapeutic plasma exchange extracorporeal membrane oxygenation unfavorable outcome (death) predicted within 72 hours (as assessed by investigator) lack of relatives consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study group<br>Multi-organ failure with acute kidney injury critically ill patients admitted to the intensive care unit undergoing regional citrate anticoagulation continuous renal replacement therapy by means of continuous veno-venous hemodiafiltration (CVVHDF). Multi-organ failure is defined as a respiratory, circulatory and renal failure. | Diagnostic Test: parathyroid hormone<br>* 10-20ml blood samples taken from the arterial catheter every 12 hours to obtain parathyroid hormone serum concentration. 6-8 samples per patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The change in parathyroid hormone serum concentration during regional citrate anticoagulation continuous renal replacement therapy (CRRT) in the acute phase of critical illness. | The first parathyroid hormone serum level will be measured before the start of CRRT (the zero point) Next measurements will be performed every 12 hours. Minimal number of measurements - 6, maximal - 8 per patient. | 96 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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acute kidney injury, parathyroid hormone, continuous renal replacement therapy, citrate anticoagulation, intensive care