Vitamin C for Acute Kidney Injury in ACLF With Septic Shock: A Randomized Controlled Trial

Inclusion Criteria: * ACLF as per asia pacific association for the study of liver (APASL criteria) with AKI according to KDIGO Criteria and septic shock. Exclusion Criteria: * • Refractory Septic shock with more than 3 organ failures. * Patients with age less than 18 years * Known severe cardiopulmonary disease (structural or valvular heart disease, coronary artery disease, COPD) * Patients in DIC with platelets \< 20,000 and INR \> 4 or active bleeding * Limitations of care (defined as refusal of cardiovascular and respiratory support modes) including "do not intubate" (DNI) status * Current hospitalization \> 15 days for patients with nosocomial acquisition of MDR at time of randomization * Known allergy or contraindication to vitamin C (including previously or currently diagnosed primary hyperoxaluria and/or oxalate nephropathy, or known/suspected ethylene glycol ingestion, * Known glucose-6-phosphate dehydrogenase (G6PD) deficiency) * Use of vitamin C at a dose of \> 1 gram daily within the 24 hours preceding first episode of qualifying organ dysfunction during a given ED or ICU admission * Patients with HCC (beyond Milan) or extrahepatic malignancies * Patients with HVOTO or EHPVO * Pregnancy or active breastfeeding * Current participation in another interventional research study * Active or history of kidney stones * History of chronic kidney disease or intrinsic kidney disease * Patients already on maintenance hemodialysis prior to pre…