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An individualized regional citrate anticoagulation protocol for hemodialysis: a real-world retrospective study

  • Nephrology - Original Paper
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Abstract

Objective

To evaluate the safety and effectiveness of an individualized regional citrate anticoagulation (RCA) protocol for hemodialysis.

Methods

In this single-center, retrospective study, blood coagulation in the extracorporeal circulation, adverse reactions, in vivo ionized calcium (iCa2+) concentrations, and the infusion dose of citrate during RCA in hemodialysis were observed in 98 patients from February 2021 to March 2022.

Results

A total of 98 patients underwent RCA during hemodialysis 362 times, and blood coagulation occurred in the extracorporeal circulation 29 times. Among the 29 cases of coagulation, most of the patients exhibited hypercoagulability, and among approximately 80% of the treatments, the deviation between the actual infusion rate of citrate in the extracorporeal circulation and the theoretical value was ± 10%. After hemodialysis, pH values and bicarbonate ion (HCO3−) levels were clearly improved, and online conductivity monitoring (OCM) values and blood coagulation scores in the extracorporeal circulation were identical to those measured in similar studies.

Conclusion

An individualized RCA protocol for hemodialysis is safe, effective, simple, and inexpensive and can meet the needs of individualized treatment; therefore, its application is worthy of promotion.

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Data availability

Data are available from the corresponding author upon reasonable request.

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Funding

This study was supported by Nanchang Medical and health science and technology Support Plan (2022-KJZC-027).

Author information

Authors and Affiliations

  1. Department of Nephrology, Gaoxin Hospital of The First Affiliated Hospital of Nanchang University, No. 7889, Changdong Avenue, Nanchang, 330096, Jiangxi, People’s Republic of China

    Yanna Fan, Feifei Wu, Menglin Zou & Laimin Luo

  2. Center of Hemodialysis, Gaoxin Hospital of The First Affiliated Hospital of Nanchang University, No. 7889, Changdong Avenue, Nanchang, 330096, Jiangxi, People’s Republic of China

    Yanyan Gong, Zhen Hu, Tin Jiang & Chenfu Gan

  3. Department of Nephrology, The First Affiliated Hospital of Nanchang University, No. 17 Yongwai Avenue, Nanchang, 330006, Jiangxi, People’s Republic of China

    Laimin Luo

Authors
  1. Yanna Fan
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  2. Feifei Wu
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  3. Menglin Zou
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  4. Yanyan Gong
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  5. Zhen Hu
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  6. Tin Jiang
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  7. Chenfu Gan
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  8. Laimin Luo
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Contributions

LL designed the study, organized the research, conducted the statistical analysis, and revised the paper; YF, FW, and MZ collected the data, conducted the statistical analysis, and wrote the paper. YG, ZH, TJ, and CG implemented the individualized protocol of regional citrate anticoagulation in hemodialysis, collected blood samples, and scored blood coagulation in the extracorporeal circulation.

Corresponding author

Correspondence to Laimin Luo.

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The authors report no conflicts of interest in this study.

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Fan, Y., Wu, F., Zou, M. et al. An individualized regional citrate anticoagulation protocol for hemodialysis: a real-world retrospective study. Int Urol Nephrol 56, 295–302 (2024). https://doi.org/10.1007/s11255-023-03677-z

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  • DOI: https://doi.org/10.1007/s11255-023-03677-z

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