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Published in: BMC Nephrology 1/2024

Open Access 01-12-2024 | Anticoagulant | Research

Construction and validation of a prediction model for the risk of citrate accumulation in patients with hepatic insufficiency receiving continuous renal replacement therapy with citrate anticoagulation

Authors: Quxia Hong, Siyu Chen, Yongchun He, Jianghua Chen, Ping Zhang

Published in: BMC Nephrology | Issue 1/2024

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Abstract

Background

To construct and validate a prediction model of the risk of citrate accumulation in patients with hepatic dysfunction receiving continuous renal replacement therapy with regional citrate anticoagulation (RCA-CRRT), which reduces the risk of citrate accumulation.

Methods

All patients who received RCA-CRRT from 2021 to 2022 and were hospitalized in the First Affiliated Hospital of Zhejiang University were considered for study participation. Logistic regression analysis was used to identify the risk factors for citrate accumulation, based on which a nomogram model was constructed and validated in the validation group.

Results

Six factors were finally identified, from which a nomogram was created to predict the risk of citrate accumulation. The area under the curve of the prediction model was 0.814 in the training group and 0.819 in the validation group, and the model showed acceptable agreement between the actual and predicted probabilities. Decision curve analysis also demonstrated that the model was clinically useful.

Conclusions

The model constructed from six factors reliably predicted the risk of citrate accumulation in patients with hepatic insufficiency who received RCA-CRRT.
Literature
1.
go back to reference Zarbock A, et al. Effect of regional citrate anticoagulation vs systemic heparin anticoagulation during continuous kidney replacement therapy on Dialysis filter life span and mortality among critically ill patients with acute kidney injury: a randomized clinical trial. Jama. 2020;324:1629–39. https://doi.org/10.1001/jama.2020.18618.CrossRefPubMed Zarbock A, et al. Effect of regional citrate anticoagulation vs systemic heparin anticoagulation during continuous kidney replacement therapy on Dialysis filter life span and mortality among critically ill patients with acute kidney injury: a randomized clinical trial. Jama. 2020;324:1629–39. https://​doi.​org/​10.​1001/​jama.​2020.​18618.CrossRefPubMed
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go back to reference Apsner R, et al. Impairment of citrate metabolism in acute hepatic failure. Wien Klin Wochenschr. 1997;109:123–7.PubMed Apsner R, et al. Impairment of citrate metabolism in acute hepatic failure. Wien Klin Wochenschr. 1997;109:123–7.PubMed
Metadata
Title
Construction and validation of a prediction model for the risk of citrate accumulation in patients with hepatic insufficiency receiving continuous renal replacement therapy with citrate anticoagulation
Authors
Quxia Hong
Siyu Chen
Yongchun He
Jianghua Chen
Ping Zhang
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Anticoagulant
Published in
BMC Nephrology / Issue 1/2024
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-024-03462-9

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