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Anticoagulation in patients with acute kidney injury undergoing kidney replacement therapy

  • Educational Review
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Abstract

Kidney replacement therapy (KRT) is used to provide supportive therapy for critically ill patients with severe acute kidney injury and various other non-renal indications. Modalities of KRT include continuous KRT (CKRT), intermittent hemodialysis (HD), and sustained low efficiency daily dialysis (SLED). However, circuit clotting is a major complication that has been investigated extensively. Extracorporeal circuit clotting can cause reduction in solute clearances and can cause blood loss, leading to an upsurge in treatment costs and a rise in workload intensity. In this educational review, we discuss the pathophysiology of the clotting cascade within an extracorporeal circuit and the use of various types of anticoagulant methods in various pediatric KRT modalities.

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Authors and Affiliations

  1. Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA

    Rupesh Raina & Ronith Chakraborty

  2. Department of Nephrology, Akron Children’s Hospital, Akron, OH, USA

    Rupesh Raina & Ronith Chakraborty

  3. UCL Department of Nephrology, Royal Free Hospital, University College London, London, UK

    Andrew Davenport

  4. Division of Nephrology, Golisano Children’s Hospital, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    Patrick Brophy

  5. Pediatric Nephrology, Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India

    Sidharth Sethi

  6. Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa

    Mignon McCulloch

  7. Pediatric Nephrology & Transplantation, Children’s Hospital of Richmond at VCU, Richmond, VA, USA

    Timothy Bunchman

  8. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Hui Kim Yap

  9. Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, Singapore, Singapore

    Hui Kim Yap

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  1. Rupesh Raina
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Answers 1. a, c, e. In this peripheral neuropathy, deep tendon reflexes are usually reduced; 2. a, b, e; 3. b, c, e.

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Raina, R., Chakraborty, R., Davenport, A. et al. Anticoagulation in patients with acute kidney injury undergoing kidney replacement therapy. Pediatr Nephrol 37, 2303–2330 (2022). https://doi.org/10.1007/s00467-021-05020-z

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  • DOI: https://doi.org/10.1007/s00467-021-05020-z

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