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Continuous Renal Replacement Therapy Intensity in Hyperammonemia
Sponsor: Hospital de Clinicas de Porto Alegre
Summary
Acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) are life-threatening conditions often associated with hyperammonemia, hepatic encephalopathy, and multi-organ dysfunction. Ammonia plays a central role in the pathogenesis of cerebral edema and neurotoxicity. Continuous renal replacement therapy (CRRT) has been shown to effectively reduce serum ammonia levels and may improve transplant-free survival in ALF. However, the optimal dialysis dose for ammonia clearance and neurological recovery remains uncertain. This randomized, multicenter clinical trial aims to compare conventional-dose (25-35 mL/kg/h) versus high-dose (45-55 mL/kg/h) CRRT in patients with ALF or ACLF and arterial ammonia \>72 μmol/L. The primary outcome is the number of coma- and delirium-free days. Secondary outcomes include ammonia clearance and additional parameters of cerebral function monitoring.
Official title: Continuous Renal Replacement Therapy Intensity in TreatIng Critical Ammonemia Levels
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
152
Start Date
2025-03-14
Completion Date
2029-05-14
Last Updated
2025-06-24
Healthy Volunteers
No
Conditions
Interventions
High-dose continuous renal replacement therapy
Continuous renal replacement therapy administered at an effluent dose of 45-55 mL/kg/h using standard equipment and protocols for critically ill patients with ALF or ACLF and hyperammonemia.
Conventional-dose continuous renal replacement therapy
Continuous renal replacement therapy administered at an effluent dose of 25-35 mL/kg/h using standard equipment and protocols for critically ill patients with ALF or ACLF and hyperammonemia.
Locations (1)
Hospital de Clinicas de Porto Alegre
Porto Alegre, Rio Grande do Sul, Brazil