{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:39:13Z","timestamp":1777729153188,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T00:00:00Z","timestamp":1585785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["16\/111\/136"],"award-info":[{"award-number":["16\/111\/136"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Intensive Care Society"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>Acute kidney injury is common in critical illness. In patients with severe acute kidney injury, renal replacement therapy is needed to prevent harm from metabolic and electrolyte disturbances and fluid overload. In the UK, continuous renal replacement therapy (CRRT) is the preferred modality, which requires anticoagulation. Over the last decade, conventional systemic heparin anticoagulation has started being replaced by regional citrate anticoagulation for CRRT, which is now used in approximately 50% of ICUs. This shift towards regional citrate anticoagulation for CRRT is occurring with little evidence of safety or longer term effectiveness. Renal replacement anticoagulant management (RRAM) is an observational comparative effectiveness study, utilising existing data sources to address the clinical and cost-effectiveness of the change to regional citrate anticoagulation for CRRT in UK ICUs. The study will use data from approximately 85,000 patients who were treated in adult, general ICUs participating in the case mix programme national clinical audit between 1 April 2009 and 31 March 2017. A survey of health service providers\u2019 anticoagulation practices will be combined with treatment and hospital outcome data from the case mix programme and linked with long-term outcomes from the Civil Registrations (deaths), Hospital Episodes Statistics for England, Patient Episodes Data for Wales, and the UK Renal Registry datasets. The primary clinical effectiveness outcome is all-cause mortality at 90-days. The study will incorporate an economic evaluation with micro-costing of both regional citrate anticoagulation and systemic heparin anticoagulation.<\/jats:p>\n                  <jats:p>Study registration: NCT03545750<\/jats:p>","DOI":"10.1177\/1751143720913417","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T01:28:11Z","timestamp":1585877291000},"page":"311-317","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Renal replacement anticoagulant management: Protocol and analysis plan for an observational comparative effectiveness study of linked data sources"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4148-3312","authenticated-orcid":false,"given":"Doug W","family":"Gould","sequence":"first","affiliation":[{"name":"Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Doidge","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Zia Sadique","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3249-1508","authenticated-orcid":false,"given":"Mark","family":"Borthwick","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fergus J","family":"Caskey","sequence":"additional","affiliation":[{"name":"United Kingdom Renal Registry, Bristol, UK and Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lui","family":"Forni","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Faculty of Health Sciences, University of Surrey, UK"},{"name":"Intensive Care Unit, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert F","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Patient Representative, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clare","family":"MacEwen","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul R","family":"Mouncey","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlies","family":"Ostermann","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Guy's and St Thomas' Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9002-9098","authenticated-orcid":false,"given":"David A","family":"Harrison","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn M","family":"Rowan","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Intensive Care National Audit & Research Centre (ICNARC), London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Duncan Young","sequence":"additional","affiliation":[{"name":"Kadoorie Centre for Critical Care Research and Education, University of Oxford, John Radcliffe Hospital, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J","family":"Watkinson","sequence":"additional","affiliation":[{"name":"Kadoorie Centre for Critical Care Research and Education, University of Oxford, John Radcliffe Hospital, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,4,2]]},"reference":[{"key":"bibr1-1751143720913417","unstructured":"ICNARC. 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