title: Risks and benefits of citrate anticoagulation for continuous renal replacement therapy.
abstract: Heparin, despite its significant side-effects, is the most commonly used anticoagulant for continuous renal replacement therapy in critical care setting. In recent years, citrate has gained much popularity by improving continuous renal replacement therapy circuit survival and decreasing blood transfusion requirements. However, its complex metabolic consequences warrant modification in the design of the citrate-based continuous renal replacement therapy protocol. With thorough understanding of the therapeutic mechanism of citrate, a simple and practicable protocol can be devised. Citrate-based continuous renal replacement therapy can be safely and widely used in the clinical setting with appropriate clinical staff training.
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: H P
authors.initials: HP
authors.lastname: Shum
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
authors.forename: W W
authors.initials: WW
authors.lastname: Yan
authors.affiliation: Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
authors.forename: T M
authors.initials: TM
authors.lastname: Chan
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use*; D002951:Citrates / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000379:methods; D011322:Primary Prevention / Q000379:methods; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D015996:Survival Rate; D013927:Thrombosis / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D002951:Citrates
keywords: Anticoagulants; Citric acid; Renal replacement therapy