Could permanent dialysis access replace catheters in ICU kidney therapy?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age ≥18 years. 2. ESKD patients on chronic hemodialysis for \>1 year in duration who are admitted to the ICU and in need of CRRT. 3. Anticipated CRRT duration ≥24 hours, based on clinical assessment of the renal trajectory. 4. Patient with functioning arteriovenous access, either arteriovenous fistula or arteriovenous graft. 5. Expected mechanical ventilation for a minimum of 12 hours, based on clinical assessment of the underlying diagnosis. 6. Expected Richmond Agitation Sedation Scale (RASS) goal of 0 or less for a minimum of 12 hours, based on clinical assessment of the underlying diagnosis. 7. Patients able to tolerate placement of an arm board at the vascular access site. 8. Baseline AVA blood flow of at least 600 mL/min for AVG and 500 mL/min for AVF during ultrasonography evaluation upon enrollment. Exclusion Criteria: 1. Age less than 18 years old. 2. Patients who receive dialysis via hemodialysis catheter or existing central catheter suitable for hemodialysis. 3. ESKD patients who, at the time of enrollment, have a sacral pressure ulcer or other clinically significant skin integrity impairment requiring frequent repositioning, extensive patient rotation, or advanced wound care management. 4. Patients with elevated INR above 5 at the time of study enrollment. 5. Patients with acute liver failure, defined as AST \>1000 U/L and/or ALT \>1000 U/L at the time of study enrollment. 6. Patients with a platelet count of less than 50,000 (10⁹ plt/L) at the time of study enrollment. 7. Patients with evidence of disseminated intravascular coagulation at the time of study enrollment. 8. Known pregnancy at the time of study enrollment. 9. Patients at high risk for rapid clinical deterioration, or those deemed unsuitable for AVA-based CRRT by the prescribing nephrologist or ICU physician.