Generalization of regional citrate anticoagulation for continuous renal replacement therapy is not associated with an increased rate of severe complications
Authors' conclusion
In an experienced team, generalization of RCA to nearly all patients requiring CRRT extended median filter lifespan without increasing the rate of significant complications.
Study context
- Population
- ICU patients receiving continuous renal replacement therapy (CRRT)1,877 circuits
- Participants
- 467 patients
- Exposure
- P2 vs P1
- P2n = 222
- P1n = 245reference
- Outcome
- Safety: therapy-associated complications incl. citrate accumulation, electrolyte and acid/base disturbances, blood transfusion requirements
Methodological detailssingle-centre, two periods
- Single-centre
- Two periods
Main finding
As reported in the abstract
Citrate accumulation (RCA circuits)
P = 0.72
Observational data: associations, not effects.
Further findings
RCA use (circuits)
P < 0.001
Patients with risk factors for citrate accumulation
P = 0.61
RCA circuits with risk factors at first circuit initiation
P = 0.002
Filter lifespan
P < 0.001
CRRT efficacy (creatinine and urea kinetics)
- Similar between the two periods
Safety
Metabolic acidosis
P = 0.01
Original publication
Generalization of regional citrate anticoagulation for continuous renal replacement therapy is not associated with an increased rate of severe complications. J Crit Care. Published 14 February 2025. doi:10.
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