Renal Replacement Anticoagulant Management (RRAM)

The University of Oxford Critical Care Research Group is working in collaboration with ICNARC to evaluate effects of different medications that prevent blood clotting during treatment to improve kidney function.

It is common for patients in intensive care units (ICUs) to have a kidney injury which prevents their kidney from working properly. If this happens the patients are treated with a machine that takes over the kidney functions and allows their own kidneys to recover. This process is called continuous renal replacement therapy (CRRT). Traditionally as part of this procedure, a medicine called heparin is added to the blood as it enters the CRRT machine to prevent the blood from clotting and clogging the machine. This process is termed anticoagulation. Recently citrate anticoagulation (an alternative to heparin) is being increasingly used in UK ICUs because it may be controllable and cheaper than the traditional heparin. However, both heparin and citrate anticoagulation are associated with different risks to the patient. Currently we do not know if one form of anticoagulation is better than the other as there have not been any direct comparisons of the effects of using heparin and citrate for CRRT.

Read our latest publication: Regional citrate anticoagulation versus systemic heparin anticoagulation for continuous kidney replacement therapy in intensive care 

For more information about the RRAM study, please visit the ICNARC website.