Randomized Controlled Trial to Evaluate Regional Citrate Anticoagulation Plus Low-Dose of Dalteparin in Continuous Veno-Venous Hemofiltration

Blood Purification

Volumn 39, Issue 4, 2015, Pages 306-312

  Wu, Buyun ^a   Zhang, Kaiyue ^a   Xu, Bin ^a   Ji, Daxi ^a   Liu, Zhihong ^a   Gong, Dehua ^a  

^a MEDICAL SCHOOL OF NANJING UNIVERSITY   (China)

Author keywords

Anticoagulation; Citrate; Continuous renal replacement therapy; Dalteparin; Low molecular weight heparin

Indexed keywords

ANTICOAGULANT AGENT; CITRIC ACID; DALTEPARIN; HEMODIALYSIS FLUID;

ADULT; ANTICOAGULANT THERAPY; ARTICLE; CATHETER; CENTRAL VENOUS CATHETERIZATION; CONTINUOUS HEMOFILTRATION; CONTINUOUS RENAL REPLACEMENT THERAPY; CONTROLLED STUDY; DISEASE SEVERITY; DRUG EFFICACY; DRUG SAFETY; FEMALE; HEMATOLOGICAL PARAMETERS; HEMODIALYSIS MACHINE; HUMAN; HYPERNATREMIA; HYPOCALCEMIA; INCIDENCE; LOADING DRUG DOSE; LOW DRUG DOSE; MAJOR CLINICAL STUDY; MALE; METABOLIC ACIDOSIS; METABOLIC ALKALOSIS; PREMATURE CLOTTING; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SURVIVAL TIME; ACUTE KIDNEY INJURY; BLOOD; BLOOD CLOTTING; CHEMISTRY; CLINICAL TRIAL; DRUG EFFECTS; HEMOFILTRATION; MIDDLE AGED; MORTALITY; PROCEDURES; TREATMENT OUTCOME;

ACUTE KIDNEY INJURY; ADULT; ANTICOAGULANTS; BLOOD COAGULATION; CITRIC ACID; DALTEPARIN; FEMALE; HEMODIALYSIS SOLUTIONS; HEMOFILTRATION; HUMANS; MALE; MIDDLE AGED; TREATMENT OUTCOME;

EID: 84930240023     PISSN: 02535068     EISSN: 14219735     Source Type: Journal    
DOI: 10.1159/000381662     Document Type: Article

References (28)

1. Tolwani A: Continuous renal-replacement therapy for acute kidney injury. N Engl J Med 2012; 367:2505-2514.
2. Tolwani AJ, Wille KM: Anticoagulation for continuous renal replacement therapy. Semin Dial 2009; 22:141-145.
3. Oudemans-van Straaten HM, Bosman RJ, Koopmans M, van der Voort PH, Wester JP, van der Spoel JI, Dijksman LM, Zandstra DF: Citrate anticoagulation for continuous veno-venous hemofiltration. Crit Care Med 2009; 37:545-552.
4. Fealy N, Baldwin I, Johnstone M, Egi M, Bel-lomo R: A pilot randomized controlled cross-over study comparing regional hepariniza-tion to regional citrate anticoagulation for continuous venovenous hemofiltration. Int J Artif Organs 2007; 30:301-307.
5. Betjes MG, van Oosterom D, van Agteren M, van de Wetering J: Regional citrate versus heparin anticoagulation during venovenous hemofiltration in patients at low risk for bleeding: similar hemofilter survival but significantly less bleeding. J Nephrol 2007; 20: 602-608.
6. Kutsogiannis DJ, Gibney RT, Stollery D, Gao J: Regional citrate versus systemic heparin anticoagulation for continuous renal replace-ment in critically ill patients. Kidney Int 2005; 67:2361-2367.
7. Monchi M, Berghmans D, Ledoux D, Canivet JL, Dubois B, Damas P: Citrate vs. Heparin for anticoagulation in continuous venovenous hemofiltration: a prospective randomized study. Intensive Care Med 2004; 30:260-265.
8. Morabito S, Pistolesi V, Tritapepe L, Fiacca-dori E: Regional citrate anticoagulation for RRTs in critically ill patients with AKI. Clin J Am Soc Nephrol 2014; 9:2173-2188.
9. Tolwani A, Wille KM: Advances in continuous renal replacement therapy: citrate anticoagulation update. Blood Purif 2012; 34:88-93.
10. Meier-Kriesche HU, Finkel KW, Gitomer JJ, DuBose TD Jr: Unexpected severe hypocalce-mia during continuous venovenous hemodi-alysis with regional citrate anticoagulation. Am J Kidney Dis 1999; 33:e8.
11. Khadzhynov D, Schelter C, Lieker I, Mika A, Staeck O, Neumayer HH, Peters H, Slowinski T: Incidence and outcome of metabolic disarrangements consistent with citrate accumulation in critically ill patients undergoing continuous venovenous hemodialysis with regional citrate anticoagulation. J Crit Care 2014; 29:265-271.
12. Kramer L, Bauer E, Joukhadar C, Strobl W, Gendo A, Madl C, Gangl A: Citrate pharma-cokinetics and metabolism in cirrhotic and noncirrhotic critically ill patients. Crit Care Med 2003; 31:2450-2455.
13. Gong D, Ji D, Xu B, Xie H, Liu Y, Li L: Regional citrate anticoagulation in critically ill patients during continuous blood purification. Chin Med J (Engl) 2003; 116:360-363.
14. Mariano F, Tedeschi L, Morselli M, Stella M, Triolo G: Normal citratemia and metabolic tolerance of citrate anticoagulation for hemo-diafiltration in severe septic shock burn patients. Intensive Care Med 2010; 36:1735-1743.
15. Mariano F, Morselli M, Bergamo D, Hollo Z, Scella S, Maio M, Tetta C, Dellavalle A, Stella M, Triolo G: Blood and ultrafiltrate dosage of citrate as a useful and routine tool during continuous venovenous haemodiafiltration in septic shock patients. Nephrol Dial Transplant 2011; 26:3882-3888.
16. Mehta RL, McDonald BR, Aguilar MM, Ward DM: Regional citrate anticoagulation for continuous arteriovenous hemodialysis in critically ill patients. Kidney Int 1990; 38:976-981.
17. Palsson R, Niles JL: Regional citrate anticoagulation in continuous venovenous hemofil-tration in critically ill patients with a high risk of bleeding. Kidney Int 1999; 55:1991-1997.
18. Bihorac A, Ross EA: Continuous venovenous hemofiltration with citrate-based replacement fluid: efficacy, safety, and impact on nutrition. Am J Kidney Dis 2005; 46:908-918.
19. Naka T, Egi M, Bellomo R, Cole L, French C, Wan L, Fealy N, Baldwin I: Low-dose citrate continuous veno-venous hemofiltration (CVVH) and acid-base balance. Int J Artif Organs 2005; 28:222-228.
20. Schmitz M, Taskaya G, Plum J, Hennersdorf M, Sucker C, Grabensee B, Hetzel GR: Continuous venovenous haemofiltration using a citrate buffered substitution fluid. Anaesth Intensive Care 2007; 35:529-535.
21. Nurmohamed SA, Jallah BP, Vervloet MG, Yldirim G, ter Wee PM, Groeneveld AB: Continuous venovenous haemofiltration with citrate-buffered replacement solution is safe and efficacious in patients with a bleeding tendency: a prospective observational study. BMC Nephrol 2013; 14:89.
22. Hetzel GR, Schmitz M, Wissing H, Ries W, Schott G, Heering PJ, Isgro F, Kribben A, Himmele R, Grabensee B, Rump LC: Regional citrate versus systemic heparin for anticoagulation in critically ill patients on continuous venovenous haemofiltration: a prospective randomized multicentre trial. Nephrol Dial Transplant 2011; 26:232-239.
23. Rooden CJ, Tesselaar ME, Osanto S, Rosendaal FR, Huisman MV: Deep vein thrombosis associated with central venous catheters-a review. J Thromb Haemost 2005; 3:2409-2419.
24. PROTECT Investigators for the Canadian Critical Care Trials Group and the Australian and New Zealand Intensive Care Society Clinical Trials Group, Cook D, Meade M, Guyatt G, Walter S, Heels-Ansdell D, Warkentin TE, Zytaruk N, Crowther M, Geerts W, Cooper DJ, Vallance S, Qushmaq I, Rocha M, Ber-wanger O, Vlahakis NE: Dalteparin versus unfractionated heparin in critically ill patients. N Engl J Med 2011; 364:1305-1314.
25. Douketis J, Cook D, Meade M, Guyatt G, Geerts W, Skrobik Y, Albert M, Granton J, Hébert P, Pagliarello G, Marshall J, Fowler R, Freitag A, Rabbat C, Anderson D, Zytaruk N, Heels-Ansdell D, Crowther M, Canadian Critical Care Trials Group: Prophylaxis against deep vein thrombosis in critically ill patients with severe renal insufficiency with the low-molecular-weight heparin dalteparin: an assessment of safety and pharmacodynam-ics: the direct study. Arch Intern Med 2008; 168:1805-1812.
26. Lim W, Dentali F, Eikelboom JW, Crowther MA: Meta-analysis: low-molecular-weight heparin and bleeding in patients with severe renal insufficiency. Ann Intern Med 2006; 144:673-684.
27. Nagge J, Crowther M, Hirsh J: Is impaired renal function a contraindication to the use of low-molecular-weight heparin? Arch Intern Med 2002; 162:2605-2609.
28. Cook DJ, Rocker G, Meade M, Guyatt G, Geerts W, Anderson D, Skrobik Y, Hebert P, Albert M, Cooper J, Bates S, Caco C, Finfer S, Fowler R, Freitag A, Granton J, Jones G, Lan-gevin S, Mehta S, Pagliarello G, Poirier G, Rabbat C, Schiff D, Griffith L, Crowther M; PROTECT Investigators; Canadian Critical Care Trials Group: Prophylaxis of thrombo-embolism in critical care (PROTECT) trial: a pilot study. J Crit Care 2005; 20:364-372.