ArticleTranslational andrology and urology2026
Efficacy and safety of a novel 18 mmol/L sodium citrate hemofiltration solution in continuous renal replacement therapy for critically ill patients: a retrospective cohort study.
Article in Translational andrology and urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Continuous renal replacement therapy (CRRT) serves as a cornerstone of supportive care for critically ill patients. The selection of anticoagulation strategies and hemofiltration solutions is pivotal to the safety and efficacy of CRRT. Regional citrate anticoagulation (RCA) has been widely adopted in CRRT practice; however, it is associated with cumbersome operational procedures. Furthermore, traditional high-concentration sodium citrate anticoagulants are associated with an increased risk of metabolic complications. This study compared a novel 18 mmol/L sodium citrate hemofiltration solution with the traditional RCA protocol, with the aim of evaluating the safety, efficacy, and clinical convenience of the novel solution in CRRT for critically ill patients. Methods: This retrospective cohort study was conducted on 105 CRRT sessions in the intensive care unit (ICU) of Beijing Electric Power Hospital between July 1 and September 30, 2025. Inclusion criteria were age ≥18 years and use of CRRT with regional citrate anticoagulation (RCA). Exclusion criteria were contraindications to citrate anticoagulation, psychiatric illness, or pregnancy/lactation. Patients were divided into two groups based on the anticoagulation method: sodium citrate hemofiltration solution group (n=53) and traditional regional citrate anticoagulation (tRCA) group (n=52). We collected and compared baseline characteristics, CRRT treatment parameters, post-filter ionized calcium levels, complication rates, and workflow parameters between the two groups. Results: No significant differences were observed between the two groups in terms of gender distribution, comorbidities or disease severity indicators, including Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score. The sodium citrate hemofiltration solution group demonstrated a significantly longer mean CRRT duration compared to the tRCA group (50.91±13.07 Conclusions: Sodium citrate hemofiltration replacement solution enables effective anticoagulation, prolongs filter lifespan, reduces metabolic complications, and simplifies clinical procedures in critically ill patients undergoing CRRT. These findings support the potential utility of sodium citrate hemofiltration solution in the ICU, though confirmation in prospective trials is warranted.
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