SAfety of Regional Citrate Anticoagulation (SARCA Study)

NCT ID: NCT05339139

Last Updated: 2025-04-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-17

Study Completion Date

2025-07-31

Brief Summary

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This is an Open-label, Prospective, Multicenter Study to Assess the SAfety of Regional Citrate Anticoagulation Delivered by the multiFiltratePRO system in Adult Patients Requiring Continuous Renal Replacement Therapy (SARCA Study).

Detailed Description

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In short, AKI is a major complication in intensive care patients, often occurring in the context of multiple organ failure, and some of these patients may need CRRT. The major advantage of CRRT is improved hemodynamic stability compared to intermittent HD. Continuous anticoagulation during CRRT may be needed to prevent premature clotting of the circuit and deliver the prescribed dialysis dose. Unfractionated heparin is the most commonly used anticoagulation during CRRT mainly as a result of familiarity, low cost, and ease of administration. But the main drawback is the risk of bleeding.

An alternative technique to avoid systemic anticoagulation is regional extracorporeal anticoagulation with citrate (RCA). The advantages of RCA are improved circuit patency and fewer bleeding complications. The use of RCA may also reduce the ICU staff workload. Studies have shown longer filter running times which reduced circuit change and set-up time. In addition, anticoagulation related bleeding, and CRRT-related blood transfusions were minimized. Therefore, CRRT with RCA might be more economical than conventional anticoagulation.

The study is to explore the possibility of using the multiFiltrate PRO system with the Ci-Ca module, Cifoban® (Trisodium citrate 4%), Calrecia® (Calcium chloride dihydrate), Ci-Ca dialysate K2 and K4, AV1000 (disposable cassette), and multiBic solution in subjects who are critically ill and receiving CRRT in an acute setting.

Conditions

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Acute Kidney Injury ESRD

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

This is an open label, prospective, single-arm, multicenter study with adult patients requiring CRRT. In this study, the subjects will receive CRRT on the mFTPRO system with RCA.

RCA treatment should be used until the end of CRRT. The circuit needs to be replaced after 72 hours of running time.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ci-Ca Arm

The study population will include critically ill subjects who are a minimum of 18 years old, in an acute setting, requiring CRRT. the Subjects will receive Regional Citrate Anticoagulation (RCA) which will be delivered by MultiFiltiratePRO system

Group Type EXPERIMENTAL

Dialysis

Intervention Type COMBINATION_PRODUCT

In this study critically ill adult patients requiring Continuous Renal Replacement Therapy (CRRT) will receive Regional Citrate Anticoagulation (CRA) which will be delivered by multiFiltratePRO system.

Interventions

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Dialysis

In this study critically ill adult patients requiring Continuous Renal Replacement Therapy (CRRT) will receive Regional Citrate Anticoagulation (CRA) which will be delivered by multiFiltratePRO system.

Intervention Type COMBINATION_PRODUCT

Eligibility Criteria

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Inclusion Criteria

1. Signed informed consent form by

* The subject or
* A legally authorized representative (LAR), if the subject is unable to consent
2. Adult patients ≥ 18 years old
3. Diagnosis of AKI or End-Stage Kidney Disease (ESKD) requiring CRRT
4. Vascular access - Dialysis Catheter with size and location per institutional practice

Exclusion Criteria

1. Metabolic alkalosis as defined by serum bicarbonate greater than 30 mmol/L and arterial pH greater than 7.55
2. A female who is pregnant or breast feeding
3. Severe liver disease defined as International Normalized Ratio (INR) greater than 2.0 and total bilirubin greater than 5 mg/dl, and both aspartate aminotransferase (AST) and alanine aminotransferase (ALT) greater than 3 times upper limit of normal
4. Subjects currently enrolled in or who have completed any other investigational drug or device study within last 30 days prior to signing informed consent
5. Previous participation in a similar or the same study.
6. Subjects already on continuous renal replacement therapy
7. Subjects with active COVID-19 infection
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fresenius Medical Care North America

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Manuela Stauss-Grabo, PhD

Role: STUDY_DIRECTOR

Fresenius Medical Care North America

Locations

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John L. McClellan Memorial Veterans' Hospital

Little Rock, Arkansas, United States

Site Status COMPLETED

University of Arkansas for Medical Sciences (UAMS)

Little Rock, Arkansas, United States

Site Status RECRUITING

Advent Health Orlando

Orlando, Florida, United States

Site Status NOT_YET_RECRUITING

UMass Memorial Medical Center

Worcester, Massachusetts, United States

Site Status RECRUITING

University of Michigan

Ann Arbor, Michigan, United States

Site Status COMPLETED

Henry Ford Hospital

Detroit, Michigan, United States

Site Status RECRUITING

Mayo Clinic

Rochester, Minnesota, United States

Site Status COMPLETED

University of Mississippi Medical Center

Jackson, Mississippi, United States

Site Status RECRUITING

Washington University - Hospital

St Louis, Missouri, United States

Site Status COMPLETED

Intermountain Health

Murray, Utah, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Anja Derlet-Savoia, PhD

Role: CONTACT

+49 173 965 9356

Manuela Stauss-Grabo, PhD

Role: CONTACT

+49 1525 469 1929

Facility Contacts

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Alperdis L Keyes

Role: primary

Ann McCarthy

Role: primary

Emmy Abraham

Role: primary

Catherine Wells

Role: primary

Anitha Vijayan

Role: primary

Other Identifiers

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Ci-Ca-001

Identifier Type: -

Identifier Source: org_study_id

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