title: A prospective, randomized, double-blind crossover study on the use of 5% citrate lock versus 10% citrate lock in permanent hemodialysis catheters.
abstract: Central venous catheters are used as permanent vascular access for chronic hemodialysis when construction of an arteriovenous fistula is not possible or contraindicated. We prospectively evaluated the efficacy and safety of a 5% citrate versus 10% citrate catheter lock for permanent single-lumen dialysis catheters in a double-blind, crossover study of 28 patients during 1,876 dialysis sessions. There was a slightly higher number of dialysis sessions with clot formation in the 5% citrate group; entirely attributable to the formation of small clots. There was no statistically significant difference in the formation of large clots, complete obstruction of the catheter or the need for urokinase between the 2 study groups. In view of the ongoing debate on the safety of high-concentration citrate catheter locks, we conclude that a 5% citrate lock is equally efficient in preventing catheter dysfunction compared with a 10% citrate lock and is therefore the preferred citrate catheter-locking solution.
authors.affiliation: Department of Nephrology and Renal Transplantation, University Hospitals Leuven, University of Leuven, Leuven, Belgium.
authors.forename: Gert
authors.initials: G
authors.lastname: Meeus
authors.forename: Dirk R J
authors.initials: DR
authors.lastname: Kuypers
authors.forename: Kathleen
authors.initials: K
authors.lastname: Claes
authors.forename: Pieter
authors.initials: P
authors.lastname: Evenepoel
authors.forename: Bart
authors.initials: B
authors.lastname: Maes
authors.forename: Yves
authors.initials: Y
authors.lastname: Vanrenterghem
mesh_terms: D000368:Aged; D001777:Blood Coagulation / Q000187:drug effects; D002405:Catheterization, Central Venous / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects*; D019343:Citric Acid / Q000494:pharmacology*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004868:Equipment Failure; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*
chemical_list: D019343:Citric Acid