Author/Editor		Buturović, Jadranka; Gubenšek, Jakob; Černe, Darko; Ponikvar, Rafael
Title		Standard citrate versus sequential citrate/anticoagulant-free anticoagulation during hemodyalisis: a randomized trial
Type		članek
Source		Artif Organs
Vol. and No.		Letnik 32, št. 1
Publication year		2008
Volume		str. 77-81
Language		eng
Abstract		In a randomized study, sequential anticoagulation for hemodialysis (citrate for the first 3.5 h, switching to 30-min anticoagulation-free hemodialysis) was compared to standard citrate anticoagulation. Fifty-two hemodialysis procedures were randomized either to sequential (n = 27) or standard citrate group (n = 25). The antithrombotic effect in the circuit was visually assessed after hemodialysis using a score from 1 (total clotting) to 5 (no clotting). The antitbrombotic score for sequential versus standard group was as follows: dialyzer, 4.0 +- 1.1 versus 4.8 +- 0.4 (P < 0.07 ); arterial bubble trap, 4.0 +- 1.2 versus 4.7 +- 0.6 (P = 0.013); venous bubble trap, 4.0 +- 1.3 versus 4.8 +- 0.6 (P < 0.01). Serum citrate levels during sequential versus standard citrate anticoagulation (μmol/L) were as follows: at the beginning, 143+- 65 versus 148 +- 77 (not significant (NS]); after 2 h, 317 `- 157 versus 354 +- 111 (NS); at the end, 125 +- 81 versus 405 +- 133 (P < 0.01). Sequential anticoagulation reduces the final serum citrate concentration to predialysis level. It can be a good anticoagulation strategy for patients in whom the reduction of citrate load is desired. Key Words: Anticoagulation-Citrate-Hemodialysis-Metabolic alkalosis-Regional citrate anticoagulation-Serum citrate levels.
Descriptors		HEMODIALYSIS HEMODIALYSIS SOLUTIONS CITRATES ANTICOAGULANTS ALKALOSIS RANDOMIZED CONTROLLED TRIALS