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Pediatric Nephrology
Published in: Pediatric Nephrology 3/2014

Open Access 01-03-2014 | Original Article

Citrate anticoagulation for continuous renal replacement therapy in small children

Authors: Jolanta Soltysiak, Alfred Warzywoda, Bartłomiej Kociński, Danuta Ostalska-Nowicka, Anna Benedyk, Magdalena Silska-Dittmar, Jacek Zachwieja

Published in: Pediatric Nephrology | Issue 3/2014

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Abstract

Background

Regional citrate anticoagulation (RCA) is one of the methods used to prevent clotting in continuous renal replacement therapy (CRRT). The aim of this study was to describe the outcomes and complications of RCA-CRRT in comparison to heparin anticoagulation (HA)-CRRT in critically ill children.

Methods

This study was a retrospective review of 30 critically ill children (16 on RCA- and 14 on HA-CRRT) who underwent at least 24 h of CRRT. The mean body weight of the children was 8.69 ± 5.63 kg. RCA-CRRT was performed with a commercially available pre-dilution citrate solution (Prismocitrate 18/0).

Results

The mean time on RCA-CRRT and HA-CRRT was 148.73 ± 131.58 and 110.24 ± 105.38 h, respectively. Circuit lifetime was significantly higher in RCA-CRRT than in HA-CRRT (58.04 ± 51.18 h vs. 37.64 ± 32.51 h, respectively; p = 0.030). Circuit clotting was observed in 11.63 % of children receiving RCA-CRRT and 34.15 % of those receiving HA-CRRT. Episodic electrolyte and metabolic disturbances were more common in children receiving RCA-CRRT. The survival at discharge from the hospital was 37.5 and 14.3 % among children receiving RCA-CRRT and HA-CRRT, respectively.

Conclusions

In critically ill children with a low body weight, RCA appeared to be safe and easy to used. Among our patient cohort, RCA was more effective in preventing circuit clotting and provided a better circuit lifetime than HA.
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Metadata
Title
Citrate anticoagulation for continuous renal replacement therapy in small children
Authors
Jolanta Soltysiak
Alfred Warzywoda
Bartłomiej Kociński
Danuta Ostalska-Nowicka
Anna Benedyk
Magdalena Silska-Dittmar
Jacek Zachwieja
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 3/2014
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-013-2690-6

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