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Trial registered on ANZCTR
Registration number
ACTRN12616000045415
Ethics application status
Approved
Date submitted
11/01/2016
Date registered
19/01/2016
Date last updated
19/01/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
A prospective randomised study conducted in an adult intensive care unit to compare the biochemical and acid-base effects of two solutions used during continuous renal replacement therapy (CRRT).
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Scientific title
Biochemical and acid-base effects of two predilution haemofiltration solutions containing different concentrations of trisodium citrate, in critically ill patients undergoing continuous renal replacement therapy.
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Secondary ID [1]
288271
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Nil
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Universal Trial Number (UTN)
U1111-1178-2864
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Trial acronym
BEaRSS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute kidney failure
297222
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Condition category
Condition code
Renal and Urogenital
297425
297425
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Continuous veno-venous haemofiltration (CVVHF) using a new predilution haemofiltration solution containing 15mmol/L of trisodium citrate as the anticoagulant.
CVVHF is conducted routinely in the Intensive Care Unit (ICU) when patients with critical illness require kidney support. The treatment regime lasts, on average, about five days though there is considerable variation in length of treatment. The patients are usually simultaneously undergoing some type of ventilatory support.
Blood samples are routinely taken on at least a daily basis whilst the patients are receiving CVVHF.
The occurrence of adverse events is monitored and if noted, dealt with in a timely and appropriate manner.
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Intervention code [1]
293562
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Treatment: Devices
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Intervention code [2]
293607
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Treatment: Other
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Comparator / control treatment
The control group will use the standard 18mmol/L trisodium citrate haemofiltration solution as predilution during continuous veno-venous haemofiltration.
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Control group
Active
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Outcomes
Primary outcome [1]
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The difference in standard base excess between the two groups being studied.
The SBE forms part of the normal blood gas report and the numerical result for the SBE was recorded from the serial arterial blood gas analyses taken as part of the routine care of all ICU patients.
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Assessment method [1]
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Timepoint [1]
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Standard base excess was compared between the two groups on enrolment and on day 3 and day 5 of CRRT treatment.
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Secondary outcome [1]
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Mortality rate between the two groups.
This outcome was assessed by chart audit.
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Assessment method [1]
319805
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Timepoint [1]
319805
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On discharge from the ICU.
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Eligibility
Key inclusion criteria
Non-pregnant adult patients who require extracorporeal support for acute kidney failure while being treated in an intensive care unit (ICU).
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Age under 18 years.
Pregnancy.
Weight > 100kgs
Advanced hepatic disease
Predicted to die within 24 hours of admission to the ICU
Allergy/hypersensitivity to citrate compounds.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Blocked design
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
A previous retrospective audit had identified a rise in SBE to approximately 7.0meq/L (SD 3.5meq/L) by day 5 in patients receiving CVVHF using C18 anticoagulation compared to a mean rise to 3.5meq/L (SD 3.5meq/L) in patients receiving CVVHF using non-citrate anticoagulation (heparin). Assuming a power of 0.80, a level of significance of 0.05 and a 20% dropout rate in a two-sided experiment, gave a total of 2x25 (50) patients required to detect a difference in SBE between the groups of 3.5meq/L.
Continuous parametric data were compared using the Student t-test and reported as mean and standard deviation (SD). Non-parametric data were compared using the Mann-Whitney test and reported as median and interquartile range (IQR). Categorical and proportionate data were compared using a chi-square test for proportions. Where required, normality was checked using a Shapiro-Wilk test.
A longitudinal and correlated regression analysis was performed where time based repeated measures were encountered.
Time to event data were modelled using Cox regression whilst factors specifically influencing mortality were modelled using logistic regression.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
28/08/2013
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Date of last participant enrolment
Anticipated
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Actual
1/04/2015
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
50
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Accrual to date
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Final
53
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
5005
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Nambour General Hospital - Nambour
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Recruitment postcode(s) [1]
12501
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4560 - Nambour
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Funding & Sponsors
Funding source category [1]
292652
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Self funded/Unfunded
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Name [1]
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Not applicable
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Address [1]
292652
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Not applicable
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Country [1]
292652
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Primary sponsor type
Hospital
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Name
Nambour General Hospital
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Address
PO Box 547
Nambour
Queensland
4560
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
291370
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Country [1]
291370
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294126
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Royal Brisbane and Women's Hospital
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Ethics committee address [1]
294126
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Metro North Hospital and Health Service Herston Brisbane Queensland 4006
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Ethics committee country [1]
294126
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Australia
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Date submitted for ethics approval [1]
294126
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13/08/2012
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Approval date [1]
294126
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20/08/2012
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Ethics approval number [1]
294126
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HREC/12/QRBW/252
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Summary
Brief summary
The primary aim of this study is to examine the association between the citrate concentration in haemofiltration fluid and the resulting Standard Base Excess (SBE) after several days of CVVHF. We expect to confirm that performing CVVHF using a relatively high citrate concentration HF (18.0mmol/l) results in an elevation of SBE. We expect to show that using a lower citrate concentration HF (15.0mmol/l) results in much less elevation of SBE. We also expect to show that use of the lower citrate concentration HF results in an acceptable filter life.
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Trial website
N/A
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Trial related presentations / publications
Results were presented at the local Nambour General Hospital Research Forum in September 2015. No citation or abstract is available. Results were presented at the European Society of Intensive Care Medicine conference in Berlin, Germany in November 2015. Anstey CM, Richardson AC, Campbell VK A comparison between 2 dilute citrate solutions (15mmol/l vs 18 mmol/l) in continuous renal replacement therapy: the base excess and renal replacement solution (BEARRS) study Intensive Care Medicine (Experimental) 2015; 3: A842 A manuscript suitable for publication has been drafted and is awaiting final proofing prior to submission for peer review.
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Public notes
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Attachments [1]
716
716
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/AnzctrAttachments/369882(v18-01-2016-13-03-24)-BEaRSS Study Protocol.docx
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Contacts
Principal investigator
Name
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Dr Chris Anstey
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Address
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c/- Intensive Care Unit
Nambour General Hospital
SCHHS
PO Box 547
Nambour
Queensland 4560
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Country
62586
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Australia
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Phone
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+617 5470 6780
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Fax
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+617 5470 6841
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Email
62586
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[email protected]
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Contact person for public queries
Name
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Chris Anstey
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Address
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c/- Intensive Care Unit
Nambour General Hospital
SCHHS
PO Box 547
Nambour
Queensland 4560
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Country
62587
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Australia
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Phone
62587
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+617 5470 6780
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Fax
62587
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+617 5470 6841
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Email
62587
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[email protected]
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Contact person for scientific queries
Name
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Chris Anstey
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Address
62588
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c/- Intensive Care Unit
Nambour General Hospital
SCHHS
PO Box 547
Nambour
Queensland 4560
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Country
62588
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Australia
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Phone
62588
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+617 5470 6780
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Fax
62588
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+617 5470 6841
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Email
62588
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A Comparison between Two Dilute Citrate Solutions (15 vs. 18 mmol/l) in Continuous Renal Replacement Therapy: The Base Excess and Renal Substitution Solution Study.
2016
https://dx.doi.org/10.1159/000446979
N.B. These documents automatically identified may not have been verified by the study sponsor.
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