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Anticoagulation, delivered dose and outcomes in CRRT: The program to improve care in acute renal disease (PICARD). Hemodialysis international. International Symposium on Home Hemodialysis Claure-Del Granado, R., Macedo, E., Soroko, S., Kim, Y., Chertow, G. M., Himmelfarb, J., Ikizler, T. A., Paganini, E. P., Mehta, R. L. 2014; 18 (3): 641-649

Abstract

Delivered dialysis dose by continuous renal replacement therapies (CRRT) depends on circuit efficacy, which is influenced in part by the anticoagulation strategy. We evaluated the association of anticoagulation strategy used on solute clearance efficacy, circuit longevity, bleeding complications, and mortality. We analyzed data from 1740 sessions 24?h in length among 244 critically ill patients, with at least 48?h on CRRT. Regional citrate, heparin, or saline flushes was variably used to prevent or attenuate filter clotting. We calculated delivered dose using the standardized Kt/Vurea . We monitored filter efficacy by calculating effluent urea nitrogen/blood urea nitrogen ratios. Filter longevity was significantly higher with citrate (median 48, interquartile range [IQR] 20.3-75.0 hours) than with heparin (5.9, IQR 8.5-27.0 hours) or no anticoagulation (17.5, IQR 9.5-32 hours, P?

View details for DOI 10.1111/hdi.12157

View details for PubMedID 24620987