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The Effect of Citrate on Clot Formation, Dialyzer Reuse, and Anemia in Hemodialysis Patients.
Trakarnvanich, Thananda; Thirathanakul, Saowanee; Sriphueng, Nongnaphat; Thumrongthongjaroon, Pathitta; Kurathong, Sathit; Ngamvichchukorn, Tanun; Trakarnvanich, Thananda.
Affiliation
  • Trakarnvanich T; Renal Unit, Department of Medical, Faculty of Medicine, Navamindradhiraj University, Bangkok, Thailand, thananda@hotmail.com.
  • Thirathanakul S; Renal Unit, Department of Medical, Faculty of Medicine, Navamindradhiraj University, Bangkok, Thailand.
  • Sriphueng N; Ruenruedee Dialysis Clinic, Bangkok, Thailand.
  • Thumrongthongjaroon P; Bangpai Dialysis Center, Bangkok, Thailand.
  • Kurathong S; Renal Unit, Department of Medical, Faculty of Medicine, Navamindradhiraj University, Bangkok, Thailand.
  • Ngamvichchukorn T; Renal Unit, Department of Medical, Faculty of Medicine, Navamindradhiraj University, Bangkok, Thailand.
Blood Purif ; 47(4): 361-368, 2019.
Article in En | MEDLINE | ID: mdl-30544124
ABSTRACT

BACKGROUND:

Citrate anticoagulation is increasingly favored for preventing extracorporeal circuit clotting during renal replacement therapy. This study tested the effect of citrate compared with acetate on heparin avoidance and other parameters.

METHODS:

Sixty-one chronic hemodialysis (HD) patients were switched from conventional dialysis fluid (acetate) to citrate dialysis fluid and were treated in 3 phases, each lasting 4 weeks 50%, 25%, and no heparin. Visual clotting score, erythropoiesis stimulating agent (ESA) dose, and laboratory parameters were measured.

RESULTS:

Except for 2 episodes of clotting, the same dialyzers were used throughout each citrate phase. The mean visual clotting scores were comparable across study periods. Hemoglobin decreased slightly in phase 2 despite the constant ESA dose. The ionized calcium levels rose after HD in most sessions. No adverse events occurred during citrate dialysis.

CONCLUSION:

During citrate dialysis in chronic HD patients, heparin can be completely avoided. The electrolyte levels, the adequacy of dialysis, and hemoglobin can be maintained without significant adverse events.
Subject(s)
Key words

Full text: 1 Database: MEDLINE Main subject: Blood Coagulation / Dialysis Solutions / Renal Dialysis / Citric Acid / Anemia / Anticoagulants Type of study: Diagnostic_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Blood Purif Year: 2019 Type: Article

Full text: 1 Database: MEDLINE Main subject: Blood Coagulation / Dialysis Solutions / Renal Dialysis / Citric Acid / Anemia / Anticoagulants Type of study: Diagnostic_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Blood Purif Year: 2019 Type: Article