title: Comparison of the AN69ST Membrane versus Citrate-Enriched Dialysate on Clotting Events during Hemodialysis without Systemic Anticoagulation.
abstract: BACKGROUND
  The optimal management of anticoagulation in hemodialyzed patients with a high risk of bleeding is controversial.
  
  
  METHODS
  We compared premature termination of dialysis caused by clotting events between AN69ST membranes (G1) and 0.8 mmol/L citrate-enriched dialysate (G2). The number of sessions that had increased venous pressure (VP) and variations in urea-reduction ratio (URR) were analyzed.
  
  
  RESULTS
  Six hundred and two sessions were analyzed in 259 patients: 22.4% had sessions that ended prematurely (25% in G1 and 19.1% in G2, p = ns, OR 0.60 [0.34-1.08], p = 0.08). The increase in VP was lower in G2 (23 vs. 70, p < 0.001). URR was higher in G2 (0.56 vs. 0.60, p < 0.001).
  
  
  CONCLUSIONS
  Clotting events that led to the termination of dialysis were comparable in the 2 groups. However, UUR was better in G2, and the number of patients with increased VP in the sessions was lower in G2.
  
  
  OBJECTIVE
  Our study compared the effects of the AN69ST membrane and citrate-enriched dialysate on clotting events during the dialysis of 259 patients with a high risk of bleeding. URR was significantly better and fewer cases of increased VP occurred in the citrate group compared to the AN69 ST group. No significant difference was observed regarding the need to prematurely terminate a dialysis session.
authors.affiliation: IFRNT, Department of Nephrology, Bicêtre Hospital, University of Paris-Sud, Le Kremlin-Bicêtre, France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Nseir
authors.forename: Antoine
authors.initials: A
authors.lastname: Rachas
authors.forename: Michelle
authors.initials: M
authors.lastname: Elias
authors.forename: Hélène
authors.initials: H
authors.lastname: Francois
authors.forename: Erika
authors.initials: E
authors.lastname: Nnang Obada
authors.forename: Hans Kristian
authors.initials: HK
authors.lastname: Lorenzo
authors.forename: Bernard
authors.initials: B
authors.lastname: Charpentier
authors.forename: Antoine
authors.initials: A
authors.lastname: Durrbach
authors.forename: Séverine
authors.initials: S
authors.lastname: Beaudreuil
mesh_terms: D000328:Adult; D001777:Blood Coagulation; D001794:Blood Pressure; D019343:Citric Acid / Q000494:pharmacology*; D015314:Dialysis Solutions / Q000737:chemistry / Q000494:pharmacology*; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D014508:Urea / Q000032:analysis
chemical_list: D015314:Dialysis Solutions; D008567:Membranes, Artificial; D019343:Citric Acid; D014508:Urea