Safety of Regional Citrate Anticoagulation for Kidney Injury

This study, called SARCA, is looking at the safety of a specific type of dialysis called Regional Citrate Anticoagulation (RCA) delivered by the multiFiltratePRO system. RCA is used during Continuous Renal Replacement Therapy (CRRT), a treatment for kidney failure, to prevent blood clots in the dialysis machine. This approach might reduce bleeding risks compared to standard treatments. The study aims to enroll 50 adults who have acute kidney injury (AKI) or end-stage kidney disease (ESKD) and need CRRT. Researchers will be looking at your symptoms, calcium levels, blood pH, bicarbonate, and sodium levels for up to one month to see how safe and effective this treatment is. The current recruitment status is unclear.

Study design
This is an open-label, prospective study, meaning both you and the study team will know which treatment you are receiving. It plans to enroll 50 adult participants.
What's involved
Not specified in the trial record.
Compensation
Not stated in the trial record.
Follow-up
Your symptoms and blood levels will be monitored for up to one month after starting the treatment.

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NCT05339139

SAfety of Regional Citrate Anticoagulation (SARCA Study)

Recruiting
PHASE3Ages 18+InterventionalTreatment
Fresenius Medical Care North America
~50 participants
Updated 2025-04-24 on ClinicalTrials.gov
What's tested:Dialysis

At a glance

Recruiting sites
5 of 10 listed sites are recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Symptoms and systemic ionized calcium level
Measured over Up to 1 month
+5 more outcomes measured
Acute Kidney Injury
ESRD
10 sites across 8 states
Arkansas2
Michigan2
Florida1
Massachusetts1
Minnesota1
Mississippi1
Missouri1
Utah1
  • Manuela Stauss-Grabo, PhD · STUDY_DIRECTOR · Fresenius Medical Care North America

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Eligibility criteria

Inclusion

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
  • Symptoms and systemic ionized calcium levelUp to 1 month

    Defined as a symptomatic episode of delirium, coma, nausea, vomiting, constipation, muscle weakness, hypertension, bradycardia, deemed attributable to hypercalcemia with a confirmed systemic ionized calcium \> 1.5mmol/L.

  • Arterial pH measure and bicarbonate levelUp to 1 month

    Arterial pH \> 7.55 and bicarbonate \> 30 mmol/L in the absence of exogenous bicarbonate administered

  • Serum sodium (Na) levelUp to 1 month

    Serum sodium (Na) level \> 150 mmol/L and \> 5 mmol/L rise in systemic Na above the prescribed CRRT fluids. Na level in the absence of hypertonic intravenous Na infusion

  • Drop in hemoglobin (Hgb)Up to 1 month

    Bleeding resulting in more than 2 g/dL drop in hemoglobin (Hgb) in 24-hour period or need for transfusion

  • Symptoms and systemic ionized calcium levelUp to 1 month

    defined as a symptomatic episode of tetany/spasms, seizures, deemed attributable to hypocalcemia and with a confirmed systemic iCa \< 0.85 mmol/L.

  • Symptoms and total-to-ionized calcium ratioUp to 1 month

    Patients with impaired citrate metabolism or citrate overdose can exhibit citrate accumulation. Symptomatic citrate accumulation presents with symptoms of tetany/spasms, seizures, systemic hypocoagulability, hypotension, or cardiac events; and should be confirmed with: 1. A total-to-ionized calcium ratio \> 2.5; OR 2. A total-to-ionized calcium ratio greater than 2.25 together with one or more of the following criteria: 1. an increase in calcium supplementation, 2. decreasing systemic ionized calcium, and 3. metabolic acidosis. When a clinical presentation is possibly associated with an abnormal concentration of systemic ionized calcium or an altered acid-base balance, the labs ({Calcium: systemic ionized calcium, post-filter ionized calcium and total calcium}, bicarbonate, sodium, potassium, magnesium, phosphate) should be checked immediately.