Accelerated vs Standard Approach to Continuous Veno-venous Hemodiafiltration Post-hemoperfusion (ASAP) in Severe Acute Diquat Poisoning

Launched by THE AFFILIATED NANJING DRUM TOWER HOSPITAL OF NANJING UNIVERSITY MEDICAL SCHOOL · May 4, 2025

Keywords

ClinConnect Summary

This clinical trial is studying the best way to start a treatment called continuous veno-venous hemodiafiltration (CVVHDF) in patients who have taken a harmful substance called diquat, which is found in some herbicides. Diquat poisoning can cause serious health issues, including problems with the brain, heart, and kidneys. Traditionally, doctors wait until a patient shows signs of kidney problems before starting this treatment. This trial will compare starting CVVHDF right after a procedure called hemoperfusion (which helps to filter out toxins) to the standard approach of waiting until kidney issues develop.

To participate in this trial, individuals must be at least 18 years old, have recently ingested diquat, and have a specific level of diquat in their blood when they arrive at the emergency room. People with certain medical conditions or those who are pregnant or breastfeeding cannot join. If eligible, participants can expect to receive either the accelerated treatment or the standard treatment as part of the study, helping researchers determine the best approach for future patients with diquat poisoning. This trial is currently not recruiting participants, but it aims to improve treatment options for those affected by this serious condition.

Gender

ALL

Eligibility criteria

• Inclusion criteria:
• • 1. Age ≥ 18 years; and
• • 2. A history of oral exposure to diquat solution, reported by patient(s) or their legal proxies; and
• • 3. An exposure time (time form exposure to presentation at ED) ≤ 48 hours, reported by patient(s) or their legal proxies; and
• • 4. Plasma diquat concentration measured upon ED presentation ≥ 1,000 ng/mL.
• Exclusion criteria:
• • 1. Evidence of co-ingestion of other toxic substances alongside diquat; and/or
• • 2. Withholding of CVVHDF due to limitations on the escalation of life-sustaining therapies; and/or
• • 3. Any CKRT within the previous 2 months; and/or
• • 4. Kidney transplant within the past 365 days; and/or
• • 5. Known pre-hospitalization advanced chronic kidney disease, defined by an estimated glomerular filtration rate calculated using serum creatine (eGFRer) of less than 30 mL/min/1.73 m2 by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, if pre-hospitalization serum creatine is available; and/or (6) Treating clinician(s) believe(s) that either immediate or deferral of CVVHDF initiation is mandated; and/or (7) Pregnant or breast feeding.