ArticleScience progress
Regional citrate anticoagulation prolongs filter lifespan and improves metabolic control in CRRT for liver dysfunction-associated AKI: A retrospective cohort study.
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5 authors.
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Abstract
ObjectiveIt is to evaluate the efficacy and safety of regional citrate anticoagulation (RCA) in patients with hepatic insufficiency who develop acute kidney injury (AKI) and require continuous renal replacement therapy (CRRT).MethodsThis single-center retrospective cohort study included intensive care unit (ICU) patients with hepatic insufficiency-associated AKI who were treated with CRRT between May 2024 and May 2025. After excluding incomplete records and performing 1:1 propensity score matching, 66 patients were analyzed: 39 received RCA and 27 received systemic heparin or no anticoagulation (non-RCA). Clinical characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Child-Pugh class, filter lifespan, coagulation indices, metabolic parameters, and adverse events were also collected. The primary endpoints were filter lifespan, bleeding, and citrate accumulation. The secondary endpoints included filter lifespan, bleeding, citrate accumulation, treatment-related metabolic, coagulation changes and 28-day mortality. Multivariate logistic regression and receiver operating characteristic analyses were performed.ResultsBaseline illness severity was higher in the RCA group (APACHE II 30.46 ± 7.1 vs. 16.07 ± 5.3,
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