CA-CIBLE : Impact of increasing the ionized serum calcium target post-filter on the effectiveness of regional citrate anticoagulation during continuous extra-renal purification in intensive care: multicenter randomized controlled non-inferiority study.

When people are very unwell and in intensive care, their kidneys might struggle to work properly. In these situations, a treatment called Continuous Renal Replacement Therapy (CRRT) can be used to help clean their blood, much like kidneys do. During CRRT, blood is taken out of the body, passed through a special filter that removes waste products, and then returned to the body. To stop the blood from clotting in the filter, a special medicine called citrate is often added. While citrate is very effective at preventing clots, it can sometimes affect the calcium levels in a patient's blood.

This study, called CA-CIBLE, is looking into whether adjusting the calcium levels in the blood, specifically *after* it has passed through the CRRT filter, can make a difference. The doctors are wondering if a slightly higher level of calcium in this area might help the filters work better and for longer without getting blocked. They want to make sure that increasing this calcium target doesn't cause any new problems, but instead keeps the filters running smoothly, which is important for patients needing this life-saving treatment.

The main thing the study will measure is how often the filters clot. Researchers will also be checking how long each filter works before it needs to be changed, and why it might have stopped working (for example, if it clotts, or if the patient needs to move). They will also keep a close eye on other things like how much citrate is used, whether calcium levels in the patient’s body remain balanced, and if there are any other changes in important body salts like magnesium or sodium. This information will help doctors understand the best way to use CRRT with citrate to give patients the best possible care.