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[Comparison of citrate 4% and heparin as tunneled-catheters-locking solution in chronic hemodialysis]

Guillaume Chazot1, Manolie Mehdi1, Christie Lorriaux1

  • 1NephroCare Tassin-Charcot, 7, avenue du Maréchal-Foch, 69110 Saint-Foy-lès-Lyon, France.

Nephrologie & Therapeutique
|December 2, 2017
PubMed

Insights

Citrate 4% is a safe and effective alternative to heparin for catheter locking in hemodialysis patients. It shows similar catheter function and dialysis adequacy, with fewer plasminogen-tissular activator uses and lower costs.

Area of Science:

  • Nephrology
  • Vascular Access Management
  • Biomaterials

Background:

  • Chronic hemodialysis necessitates reliable vascular access.
  • Catheter-locking solutions prevent thrombosis and infection.
  • Heparin has been the standard, but alternatives are sought.

Purpose of the Study:

  • To compare 4% citrate with heparin as a catheter-locking solution.
  • To evaluate catheter dysfunction, dialysis adequacy, plasminogen-tissular activator (TPA) use, and costs.
  • To assess the safety and efficacy of citrate in chronic hemodialysis.

Main Methods:

  • Prospective, monocentric cohort study.
  • 49 prevalent chronic hemodialysis patients were divided into heparin (n=26) and citrate (n=22) groups.
  • Follow-up occurred from March to October 2016.

Main Results:

  • No significant difference in catheter dysfunction rates (4.23% heparin vs. 4.14% citrate).
  • Similar dialysis adequacy was observed between groups.
  • Citrate use was associated with significantly lower TPA use (P=0.022) and reduced costs (€1.42 vs. €2.94 per session).
  • Higher prevalence of diabetes in the citrate group (P=0.025).

Conclusions:

  • Citrate 4% is non-inferior to heparin for catheter locking in hemodialysis.
  • Citrate demonstrates comparable catheter function and dialysis adequacy.
  • Citrate offers benefits of reduced TPA use and lower costs.
Abstract

Keywords:
Activateurs tissulaires du plasminogèneCatheter dysfunction episodesCatheter-locking solutionCitrateCostsCoûtsDialysis adequacyDysfonction de cathéterHemodialysisHeparinHémodialyseHéparinePlasminogen-tissular activatorsQualité de dialyseVerrou de cathéter

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