Heparin-free regional anticoagulation of haemodialysis filters with calcium-free dialysate: is citrate mandatory? Article Swipe
Chloé Médrano
,
Olivier Cointault
,
Laurence Lavayssière
,
Marie‐Béatrice Nogier
,
Éloïse Colliou
,
Nicolas Setbon
,
Nassim Kamar
,
Stanislas Faguer
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1093/ckj/sfab087
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1093/ckj/sfab087
Background There is an unmet need to develop safe and successful heparin-free regional anticoagulation modalities in haemodialysed patients at risk of bleeding. Whether the addition of citrate as a prefilter injection or in the dialysate itself is required to reach anticoagulation objectives when calcium-free dialysate is used as regional anticoagulation remains unclear. Methods In this monocentric retrospective study, we report our experience of 908 dialysis sessions performed with a calcium-free citrate-containing dialysate and calcium reinjection according to the ionic dialysance, without additional heparin. Results Premature termination for filter clotting occurred in 20 sessions (2.2%) and duration of session was >4.5 h in 135 (15%; maximum duration 6 h). In addition, we could investigate the citrate, calcium and acid–basis status during haemodialysis sessions performed with (citrate group, n = 20 sessions) or without (citrate-free group, n = 19 sessions) citrate in the dialysate. In 20 sessions performed in patients with underlying liver disorders and using calcium-free citrate-containing dialysate, patients’ ionized calcium (iCa) and serum citrate levels were stable and remained within the normal range, respectively. Post-filter iCa was below 0.4 mmol/L in 19/20 sessions and citrate was 0.304 mmol/L (range: 0.011; 0.548). In 19 sessions that used calcium and citrate-free dialysate, post-filter iCa was 0.41 mmol/L (0.34; 0.5) and all sessions extended to 4 h or beyond. Conclusions Regional anticoagulation of haemodialysis with a calcium-free dialysate and calcium reinjection according to the ionic dialysance is safe. Adding citrate to the dialysate is not mandatory to prevent dialysis circuit clotting in most patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ckj/sfab087
- OA Status
- gold
- Cited By
- 10
- References
- 22
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3172741066
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3172741066Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/ckj/sfab087Digital Object Identifier
- Title
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Heparin-free regional anticoagulation of haemodialysis filters with calcium-free dialysate: is citrate mandatory?Work title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2021Year of publication
- Publication date
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2021-04-23Full publication date if available
- Authors
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Chloé Médrano, Olivier Cointault, Laurence Lavayssière, Marie‐Béatrice Nogier, Éloïse Colliou, Nicolas Setbon, Nassim Kamar, Stanislas FaguerList of authors in order
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https://doi.org/10.1093/ckj/sfab087Publisher landing page
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
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https://doi.org/10.1093/ckj/sfab087Direct OA link when available
- Concepts
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Calcium, Medicine, Heparin, Citric acid, Calcium metabolism, Dialysis, Hemodialysis, Urology, Surgery, Chemistry, Internal medicine, BiochemistryTop concepts (fields/topics) attached by OpenAlex
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10Total citation count in OpenAlex
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2024: 6, 2023: 4Per-year citation counts (last 5 years)
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22Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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