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Related Concept Videos

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Related Experiment Video

Updated: Mar 2, 2026

Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema
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Citrate Anticoagulation during Continuous Renal Replacement Therapy.

Davide Ricci, Laura Panicali, Maria Grazia Facchini

    Contributions to Nephrology
    |May 24, 2017
    PubMed
    Summary
    This summary is machine-generated.

    Regional anticoagulation (RCA) with citrate offers a safer alternative to heparin for continuous renal replacement therapy (CRRT). Citrate reduces bleeding complications and improves dialysis dose delivery, enhancing patient outcomes in CRRT.

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    Area of Science:

    • Nephrology
    • Critical Care Medicine
    • Pharmacology

    Background:

    • Heparin is a common anticoagulant for extracorporeal dialysis but can cause hemorrhagic complications (5-30%) during continuous renal replacement therapy (CRRT).
    • Citrate chelates calcium, inhibiting the coagulation cascade and enabling regional anticoagulation (RCA) within the extracorporeal circuit, thus avoiding systemic anticoagulation.

    Purpose of the Study:

    • To evaluate the efficacy and safety of citrate-based regional anticoagulation (RCA) compared to heparin for continuous renal replacement therapy (CRRT).
    • To assess the impact of citrate RCA on bleeding incidence, filter lifespan, and dialysis dose delivery.

    Main Methods:

    • A shift towards citrate-based RCA for CRRT was implemented.
    • Data on filter usage, prescribed vs. delivered dialysis doses, and bleeding complications were collected and analyzed.

    Main Results:

    • Citrate RCA demonstrated a reduced incidence of bleeding complications compared to heparin.
    • Filter utilization decreased from 2.4 to 1.3 filters per 72 hours.
    • The gap between prescribed and delivered dialysis doses narrowed significantly from 22% to 7%.

    Conclusions:

    • Citrate-based RCA is a safe and effective anticoagulation strategy for CRRT, superior to heparin in reducing bleeding risks.
    • Citrate RCA improves circuit efficiency and dialysis dose delivery, even in critically ill patients with liver dysfunction, due to advanced machine management systems.