Multicenter Randomized Controlled Trial Comparing Polymethyl Methacrylate and Polysulfone Membranes for Continuous Renal Replacement Therapy in Critically Ill Acute Kidney Injury Patients: A Protocol.

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Background: Acute kidney injury (AKI) is common among critically ill patients. Continuous renal replacement therapy (CRRT) is often preferred to intermittent modalities in hemodynamically unstable patients; however, premature circuit clotting and shortened filter lifetime may reduce treatment efficiency and increase clinical burden. In Japan, multiple commercially available hemofilters are used for CRRT, yet randomized evidence directly comparing specific hemofilters in the intensive care unit (ICU) setting remains limited.

Methods: The FILTER CHOICE Trial is a multicenter, randomized, open-label, parallel-group study conducted across five ICUs in Japan. Adult patients with Kidney Disease: Improving Global Outcomes (KDIGO) stage 3 AKI requiring CRRT will be randomized (1:1) to receive either a polymethyl methacrylate hemofilter (Hemofeel® CH-1.8W) or polysulfone hemofilter with embedded hydrophilic NV polymer (Hemofeel® SNV-1.0). The assigned hemofilter will be used for up to three consecutive sessions (maximum 72 h per session). The primary endpoint is hemofilter (circuit) lifetime during the first CRRT session after randomization. Secondary endpoints include hemofilter lifetime in subsequent sessions, vasopressor- and ventilator-free days, renal recovery, major adverse kidney events, mortality, biomarkers, hemodynamic indices, and 6-month health-related quality of life. The target sample size is 88 patients (44 per group).

Conclusions: This trial will evaluate whether the choice of hemofilter (Hemofeel® CH-1.8W vs. Hemofeel® SNV-1.0) affects circuit life and clinically relevant outcomes during CRRT in the ICU, providing evidence to inform hemofilter selection in routine practice.