Intermittent ADVOS vs. Hemodialysis in Non-intensive Care Patients With Liver Dysfunction

Summary

In the planned randomized controlled prospective pilot study, we aim to evaluate ADVOS compared with conventional hemodialysis regarding the elimination of protein-bound toxins in patients with therapy-refractory hepatorenal syndrome. The study will be performed in a regular non-ICU ward with a large experience in the use of the ADVOS therapy.

Eligibility

Inclusion Criteria:

* Capacity of the patient to give consent
* Pre-existing liver disease in the sense of an ACLF with HRS
* Age \>18 years
* Patient of the University Medical Center Mainz
* Bilirubin level ≥ 4 mg/dl
* Indication for renal replacement procedure is based on STARRT-AKI criteria (serum potassium ≥ 6 mmol/l in two independent blood samples; serum pH of 7.2 or less or serum bicarbonate of 12 mmol/l or less; respiratory failure secondary to volume excess)

Exclusion Criteria:

* Age \< 18 years
* Pregnancy
* Contraindications for ADVOS therapy
* Already started renal replacement therapy
* Contraindication for citrate anticoagulation
* Use of vasopressors and MAD ≤ 50 mmHg.
* Terminal cancer

Conditions5

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