Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials
Authors' conclusion
Compared to UFH, RCA is the preferred anticoagulant for critically ill patients requiring CRRT.
Study context
- Population
- Critically ill patients with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT)
- Participants
- 2,648 patients · 37 randomized controlled trials (RCTs)
- Comparison
- Anticoagulation options for CRRT vs unfractionated heparin (UFH)
- Regional-UFH + PGI2n = 46
- Outcome
- Filter lifespan
Pooled result
As reported in the abstract
MD (95% CI)
RCA vs UFH
12.0(3.8–20.2)
Regional-UFH + PGI2 vs RCAsingle RCT
37.0(12.0–62.0)
Regional-UFH + PGI2 vs LMWHsingle RCT
41.3(15.6–67.0)
Further pooled results
ICU LOS, all-cause mortality, duration of CRRT, recovery of kidney function
- No statistically significant difference among most evaluated anticoagulation options
Safety
Bleeding
- Regional citrate anticoagulation (RCA) reduced the risk of bleeding vs UFH
Adverse events
- No statistically significant difference among most evaluated anticoagulation options
Original publication
Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials. Crit Care. Published 7 June 2023. doi:10.
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