Citrate anticoagulation for continuous renal replacement therapy.

Honoré, Patrick;Rimmelé, Thomas;Joannes-Boyau, Olivier
(2024) Intensive care medicine — Vol. 50, n° 9, p. 1553-1556 (2024)

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  • Honoré, Patrickorcid-logoUCLouvain
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  • Rimmelé, Thomas
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  • Joannes-Boyau, Olivier
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Abstract
(en) Regional citrate anticoagulation (RCA) is preferred over unfractionated heparin in continuous renal replacement therapy (CRRT) due to benefits like extended filter lifespan (FLS) and reduced bleeding complications. RCA works by forming complexes with ionized calcium (iCa2+), inhibiting calcium-dependent coagulation. Citrate is administered pre-filter, and calcium is replenished post-filter. Despite advantages, RCA can cause metabolic side effects like alkalosis, acidosis, hypotension, electrolyte imbalances like hypomagnesemia, hypernatremia, and severe hypocalcemia which can lead to cardiac arrest. [...]
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Honoré, P., Rimmelé, T., & Joannes-Boyau, O. (2024). Citrate anticoagulation for continuous renal replacement therapy. Intensive care medicine, 50(9), 1553-1556. https://doi.org/10.1007/s00134-024-07531-3 (Original work published 2024)