The purpose of this study is to compare the efficacy and safety of an individualized two-stage calcium supplementation method versus a conventional commercial RCA-CRRT module in RCA-CRRT for patients with citrate metabolism disorders.
None
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Parallel
Two-stage calcium supplementation in RCA-CRRT
Other interventionThe two-stage calcium supplementation refers to: the first stage after the initiation of CRRT, the amount of calcium supplementation includes the calcium clearance from the extracorporeal circuit and the accumulated calcium citrate in the body; when the blood citrate concentration reaches a steady state, the second stage begins, at which point the accumulated calcium is stable and only the calcium clearance from the extracorporeal circuit needs to be supplemented.
Commercial RCA-CRRT module
Other interventionThe recommended supplementation method for citrate and calcium agents in the CRRT citrate module by Fresenius Medical Care.
Intervention rate of iCa
During the CRRT iCa is measured at pre-set time points. If the iCa concentration is either \<0.95 or \>1.35 mmol/L in the body, or \<0.25 or \>0.4 mmol/L in the extracorporeal circuit, it is defined as "iCa requiring intervention". If both intracorporeal and extracorporeal iCa require intervention at the same time point, it is counted as two interventions. Finally, the intervention rate of iCa is calculated.
The filter failure rate and the causes of filter failure within 72 hours
The differences and proportional distributions of in vivo and in vitro iCa values at each time point between the two groups
The incidence of bleeding events, the bleeding-related blood transfusions, and the total volume of transfused blood
The incidence of arrhythmias and neurological symptoms caused by abnormal iCa
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