title: Randomized Controlled Trial to Evaluate Regional Citrate Anticoagulation Plus Low-Dose of Dalteparin in Continuous Veno-Venous Hemofiltration.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of regional citrate anticoagulation (RCA) plus low-dose dalteparin in patients receiving continuous veno-venous hemofiltration (CVVH).
  
  
  METHODS
  Patients requiring pre-dilution CVVH at 4 l/h were randomly assigned to group A (RCA only), group B (normal-dose dalteparin anticoagulation only) or group C (RCA plus low-dose dalteparin). The primary endpoint was filter runtime and the secondary endpoints were premature clotting of the filter and anticoagulation-related side effects.
  
  
  RESULTS
  Fifty-three patients completed the study. The mean filter runtime was significantly longer in group C (40.4 ± 30.9 h) than those in group A (21.2 ± 13.5 h, p = 0.006) and group B (25.1 ± 24.0 h, p = 0.040). The rate of premature clotting, new onset of bleeding, hypocalcemia and metabolic acidosis did not differ significantly in three groups.
  
  
  CONCLUSIONS
  RCA plus low-dose dalteparin prolonged filter runtime compared with RCA only or normal-dose dalteparin only without increasing the incidence of anticoagulation-related complications.
authors.affiliation: National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors.forename: Buyun
authors.initials: B
authors.lastname: Wu
authors.forename: Kaiyue
authors.initials: K
authors.lastname: Zhang
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.forename: Daxi
authors.initials: D
authors.lastname: Ji
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Liu
authors.forename: Dehua
authors.initials: D
authors.lastname: Gong
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage*; D001777:Blood Coagulation / Q000187:drug effects; D019343:Citric Acid / Q000008:administration & dosage*; D017985:Dalteparin / Q000008:administration & dosage*; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D015312:Hemodialysis Solutions; D019343:Citric Acid; D017985:Dalteparin