Evidence map›Paper›PMID 40952919›Full record

Observational studyNephron2026

Regional Citrate Anticoagulation and Infectious Complications in Critically Ill Children and Young Adults Receiving Continuous Renal Replacement Therapy.

Katja M Gist, Sai Prasad N Iyer, H David Humes, Stuart L Goldstein, Mihaela Damian, Andrea Cappoli, Catherine Joseph, Danielle E Soranno, Michelle Starr, Ashita Tolwani and 7 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Nephron, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Katja M GistDepartment of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado, USA, katja.gist@cuanschutz.edu.
Sai Prasad N IyerSeastar Medical, Denver, Colorado, USA.
H David HumesDepartment of Medicine, University of Michigan Health, Ann Arbor, Michigan, USA.
Stuart L GoldsteinDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Mihaela DamianDepartment of Pediatrics, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Andrea CappoliBambino Gesu Children's Hospital, IRCCS, Rome, Italy.
Catherine JosephDepartment of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
Danielle E SorannoDepartment of Pediatrics, Indiana University School of Medicine and Riley Children's Hospital, Indianapolis, Indiana, USA.
Michelle StarrDepartment of Pediatrics, Indiana University School of Medicine and Riley Children's Hospital, Indianapolis, Indiana, USA.
Ashita TolwaniUniversity of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
Kevin K ChungSeastar Medical, Denver, Colorado, USA.
Theresa MottesLurie Children's Hospital, Chicago, Illinois, USA.
Huaiyu ZangDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
JangDong SeoDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Nicholas J OllberdingDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Shina MenonDepartment of Pediatrics, Lucille Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California, USA, shinam@stanford.edu.
WE-ROCK Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRecent studies have identified an association between regional citrate anticoagulation (RCA) and subsequent infectious complications during continuous renal replacement therapy (CRRT). We aimed to determine if RCA was associated with infectious complications in children and young adults receiving CRRT.

methodsA secondary analysis of the multinational Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) registry (34 centers, 9 countries), was performed, including patients from 2015 to 2018. Patients were excluded if they (1) died within 72 h of CRRT initiation, had minor trauma or were postsurgical (analysis 1), or (2) met an exclusion in analysis 1 or had sepsis prior to CRRT initiation or chronic immunosuppression (analysis 2). Multivariable mixed-effects logistic (analysis 1) and mixed-effects Cox regression (analysis 2) were used to determine the associations between anticoagulant type and culture-positive infection after CRRT initiation.

resultsA total of 874 patients were included in analysis 1 and 283 in analysis 2. Culture-positive infection occurred in 25% and 17% of each analysis. In analysis 1, culture-positive infection was higher in RCA (29%) vs. heparin (23%) and other (15%); p = 0.008. There was no association between RCA and infection in multivariable analysis. In analysis 2, there was no difference in the frequency of infection by anticoagulation type. A longer time to achieve the first negative fluid balance was associated with culture-positive infection.

conclusionRCA was not associated with culture-positive infection after CRRT initiation in this study. The systemic effects of AKI and longer time to first negative fluid balance may be inciting factors for an infection and represent a potentially modifiable factor that warrants future studies in this high-risk population.

Indexed as

AnticoagulantsCitric AcidContinuous Renal Replacement TherapyInfectionsAcute Kidney InjuryAdolescentChildChild, PreschoolCritical IllnessFemaleHumansInfantMaleRegistriesSecondary Data AnalysisYoung AdultAnticoagulantsCitric AcidCollaborativeContinuous renal replacement therapyImmune dysfunctionInfectionsPediatrics

Identifiers

PMID40952919
PMCPMC12795533

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.