nagement for achieving estimated euvolemia (e-euvolemia) in CKRT-treated patients. Methods: In a multi-center randomized controlled trial from July 2017 to July 2020, the patients with AKI requiring CKRT were eligible if the weight at the start of CKRT had increased by ≥5% compared to the weight at the time of admission, or total body water (TBW)/ height (H)2 ≥13 L/m2. We randomly assigned 208 patients to the control (conventional fluid management; N=103) and intervention groups (BIA-guided fluid management; N=105). Primary outcome was the proportion of attaining e-euvolemia seven days post-randomization. E-euvolemia was defined as the difference between TBW/H2 D7 and D0 was <–2.1 L/m2, or when TBW/H2 measured on D7 was <13 L/m2. The 28-, 60-, and 90-day mortality rate were secondary outcomes. Results: The primary outcome occurred in 34 patients in the intervention group and 27 in the control group (47% versus 41%; P=0.50). The mean value of TBW/H2 measured on D7 was the same at 13.9 L/m2 in both groups. The differences between TBW/H2 D7 and D0 were -1.13 L/m2 in the intervention group and -1.08 L/m2 in the control group (P=0.84). Patients in the intervention group had a significantly higher proportion of reaching e-euvolemia on D1 than those in the control group (13% versus 4%, P=0.02). Adverse events did not differ significantly between the groups. Conclusions: BIA-guided volume management did not affect the proportion of reaching the estimated euvolemia at seven days of the start of CKRT. Trial registration: ClinicalTrials.gov, ID: NCT03330626 (Registered on 6 November 2017; Seven study participants were retrospectively registered; nonetheless, IRB approval of each institution was completed before study participant registration). Copyright © 2024 by the American Society of Nephrology...

中文翻译：

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连续肾脏替代治疗中生物阻抗引导液体清除：VENUS 随机临床试验


CKRT 治疗患者实现估计正常血容量（e-euvolemia）的管理。方法：在2017年7月至2020年7月的一项多中心随机对照试验中，如果CKRT开始时体重较入院时体重增加≥5%，则需要CKRT的AKI患者符合资格，或者体内水分总量（TBW）/身高（H）2 ≥13 L/m2。我们将 208 名患者随机分配到对照组（传统液体管理；N=103）和干预组（BIA 指导的液体管理；N=105）。主要结局是随机化后 7 天达到正常血容量的比例。 E-euvolemia定义为TBW/H2 D7和D0之间的差异为<–2.1 L/m2，或者当D7测量的TBW/H2为<13 L/m2时。 28 天、60 天和 90 天死亡率是次要结果。结果：主要结局发生在干预组 34 名患者和对照组 27 名患者中（47% vs 41%；P=0.50）。第 7 天测量的 TBW/H2 平均值在两组中相同，均为 13.9 L/m2。干预组TBW/H2 D7与D0差异为-1.13 L/m2，对照组为-1.08 L/m2（P=0.84）。干预组患者在 D1 达到正常血容量的比例显着高于对照组（13% vs 4%，P=0.02）。各组之间的不良事件没有显着差异。结论：BIA 指导的容量管理不影响 CKRT 开始 7 天时达到估计正常血容量的比例。试验注册：ClinicalTrials.gov，ID：NCT03330626（注册于2017年11月6日；回顾性注册了7名研究参与者；尽管如此，每个机构的IRB批准都是在研究参与者注册之前完成的）。 版权所有 © 2024 美国肾脏病学会...