Is Anticoagulation Discontinuation Achievable with Citrate Dialysate during HDF Sessions?
Citrate dialysate has been developed for few years to replace acetate and HCl concentrates. In Online Postdilution Hemodiafiltration (OL-POST-HDF), several issues are remaining concerning the possibility of stopping anticoagulation during sessions and the side effects of citrate solutions on calcium metabolism. This 1-year monocentric retrospective study included all patients exposed to citrate in OL-POST-HDF with nadroparin decrease for more than one month. Clotting events, serum calcium, PTH, hemoglobin, CRP, depuration parameters, and treatments administrated were recorded for analysis. 27 patients experienced nadroparin decrease and 5 did not receive nadroparin at the end of the study. Nadroparin decrease and withdrawal were both associated with more clotting events whereas the use of vitamin K antagonists was protective. No significant metabolic side effects were observed. Citrate dialysate does not allow anticoagulation discontinuation or decrease but has no significant side effects on mineral bone metabolism or erythropoiesis.
AUB Santé, Saint-Malo Dialysis Unit, 1 rue de la Marne, 35400 Saint-Malo, France.
Thibault
0000-0001-9026-0196
T
Dolley-Hitze
Rennes 1 University, CHU Rennes Department of Clinical Pharmacology, INSERM Pharmacoepidemiology Team CIC0203 BIOSIT, 35043 Rennes, France.
Emmanuel
E
Oger
AUB Santé, Saint-Malo Dialysis Unit, 1 rue de la Marne, 35400 Saint-Malo, France.
Didier
D
Hamel
AUB Santé, Saint-Malo Dialysis Unit, 1 rue de la Marne, 35400 Saint-Malo, France.
Marie-Laure
ML
Lombart
Hôpital de Saint-Malo, Medical Laboratory, 35400 Saint-Malo, France.
Isabelle
I
Hermès