Acute kidney injury (AKI) is common in critically ill patients and is frequently associated with fluid overload, which can worsen clinical outcomes. Continuous renal replacement therapy (CRRT) allows fluid removal through net ultrafiltration (UFNET), but some patients develop hemodynamic instability or signs of poor tissue perfusion during this process.
The purpose of this prospective observational study is to evaluate tolerance to net ultrafiltration in critically ill patients with AKI receiving CRRT. The study will assess clinical, hemodynamic, ultrasound, perfusion, and biochemical parameters before and during fluid removal to identify factors associated with ultrafiltration intolerance.
The investigators hypothesize that alterations in hemodynamic, perfusion, and congestion-related parameters can identify patients at increased risk of ultrafiltration intolerance before the development of overt hypotension. The results may help improve individualized fluid removal strategies and optimize the safety of CRRT in critically ill patients.
Who can participate
Age range
18 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Age ≥18 years
* Admission to an Intensive Care Unit
* Acute kidney injury according to KDIGO criteria
* Prescription of continuous renal replacement therapy (CRRT) with net ultrafiltration
* Clinical stability considered sufficient to initiate net ultrafiltration according to the treating clinical team
Exclusion Criteria:
* Chronic kidney replacement therapy prior to ICU admission
* Pregnancy
* Limitation of therapeutic effort or goals-of-care decisions at admission or during the observation period
* Inability to perform hemodynamic or perfusion assessment
* Extracorporeal membrane oxygenation (ECMO)
* Refusal to participate in the study
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1This study is specifically looking at patients who develop 'ultrafiltration intolerance' during fluid removal with dialysis in the ICU — can you explain what that means for someone in my situation, and whether it's something we should be watching for in my care?
2Since this trial is not yet recruiting, how far away might it be from enrolling patients, and are there other similar studies or standard protocols already in place that address fluid overload during kidney replacement therapy that I could benefit from now?
3This appears to be an observational or measurement study rather than a treatment trial — does that mean participating would mainly involve monitoring rather than receiving a new or experimental treatment, and how would that affect my current care plan?
4Given that I have acute kidney injury and may need renal replacement therapy in the ICU, how does the risk of fluid overload and ultrafiltration problems factor into the decisions my team is already making about my dialysis treatment?
5Would discussing this trial with the research team help us better understand my specific risk of developing complications during fluid removal, and could that information change how my dialysis is managed even if I don't formally enroll?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Development of Ultrafiltration Intolerance
Timeframe: From UFNET initiation (T0) to 24 hours after initiation of net ultrafiltration