title: Citrate anticoagulation for continuous renal replacement therapy in small children.
abstract: BACKGROUND
  Regional citrate anticoagulation (RCA) is one of the methods used to prevent clotting in continuous renal replacement therapy (CRRT). The aim of this study was to describe the outcomes and complications of RCA-CRRT in comparison to heparin anticoagulation (HA)-CRRT in critically ill children.
  
  
  METHODS
  This study was a retrospective review of 30 critically ill children (16 on RCA- and 14 on HA-CRRT) who underwent at least 24 h of CRRT. The mean body weight of the children was 8.69 ± 5.63 kg. RCA-CRRT was performed with a commercially available pre-dilution citrate solution (Prismocitrate 18/0).
  
  
  RESULTS
  The mean time on RCA-CRRT and HA-CRRT was 148.73 ± 131.58 and 110.24 ± 105.38 h, respectively. Circuit lifetime was significantly higher in RCA-CRRT than in HA-CRRT (58.04 ± 51.18 h vs. 37.64 ± 32.51 h, respectively; p = 0.030). Circuit clotting was observed in 11.63 % of children receiving RCA-CRRT and 34.15 % of those receiving HA-CRRT. Episodic electrolyte and metabolic disturbances were more common in children receiving RCA-CRRT. The survival at discharge from the hospital was 37.5 and 14.3 % among children receiving RCA-CRRT and HA-CRRT, respectively.
  
  
  CONCLUSIONS
  In critically ill children with a low body weight, RCA appeared to be safe and easy to used. Among our patient cohort, RCA was more effective in preventing circuit clotting and provided a better circuit lifetime than HA.
authors: Department of Pediatric Cardiology and Nephrology, Poznan University of Medical Sciences, Poznan, Poland, jsoltysiak1@gmail.com.
authors: Jolanta
authors: J
authors: Soltysiak
authors: Alfred
authors: A
authors: Warzywoda
authors: Bartłomiej
authors: B
authors: Kociński
authors: Danuta
authors: D
authors: Ostalska-Nowicka
authors: Anna
authors: A
authors: Benedyk
authors: Magdalena
authors: M
authors: Silska-Dittmar
authors: Jacek
authors: J
authors: Zachwieja
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000367:Age Factors; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight; D002675:Child, Preschool; D019343:Citric Acid / Q000009:adverse effects / Q000627:therapeutic use*; D016638:Critical Illness; D005260:Female; D017583:Hemodiafiltration / Q000009:adverse effects / Q000401:mortality; D006493:Heparin / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D019343:Citric Acid; D006493:Heparin