L-carnitine as an Adjunct Treatment for Septic Shock Patients With Acute Kidney Injury

Inclusion Criteria:

• • The emergency inclusion procedure was correctly applied according to French law (signature of consent form by a patient-designated trusted person or a familymember, or a medical decision to proceed with patient inclusion if the latter twopersons are unavailable) ---- OR ---- signature of the consent form by the patient

• The patient must be insured or beneficiary of a health insurance plan

• The patient is at least 18 years old

• The patient was admitted to an intensive care unit (participating in the study)for sepsis or septic shock and presented with acute renal failure requiring, atsome point, the use of extra-renal purification.

• • The patient has sepsis or septic shock according to international criteriaSEPSIS 3 (Singer et al, The Third International Consensus Definitions forSepsis and Septic Shock (Sepsis-3) ; JAMA. 2016)

• The patient has acute renal insufficiency with an KDIGO score of 3

• The patient has started continuous renal replacement therapy (CRRT) orintermittent renal replacement therapy (IRRT) within the previous 72 hours, orwill start RRT (CRRT or IRRT) within the next 72 hours.

Exclusion Criteria:

• • The patient is participating in, or has participated in over the past threemonths, another interventional study that may interfere with the results orconclusions of this study

• The patient is in an exclusion period determined by a previous study

• The patient is under judicial protection, or is an adult under guardianship

• The patient is pregnant, parturient or breastfeeding

• The patient is susceptible to procreate and does not use methods of effectivecontraception (contraceptive hormonal ring, surgical contraception,contraceptive implant, contraceptive pill, male or female sheaths, skin patch,intrauterine contraceptive device)

• If the patient is unable to sign a consent form: the patient-designated trustedperson or family member refuses to sign the consent form

• If the patient is unable to sign a consent form: It is impossible to correctlyinform the patient-designated trusted person or family member

• The patient is able/apt to sign a consent form, but refuses to do so

• The patient is able/apt to sign a consent form, but cannot be correctlyinformed

• Septic shock without associated AKI

• Patients with a known allergy to L-Carnitine or other component of levocarniloral solution or for injection

• Pre-existing chronic disease requiring dialysis

• The patient has stage 4 CKD with baseline DFG (CDK) if known <30 ml

• History of seizures or epilepsy

• Chronic bowel disease or history of chronic diarrhoea

• Under treatment with sodium valproate