ReviewClinical journal of the American Society of Nephrology : CJASN2014
Regional citrate anticoagulation for RRTs in critically ill patients with AKI.
Review in Clinical journal of the American Society of Nephrology : CJASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 63 papers, 3 of them syntheses that pooled 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.
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.
Simplified Regional Citrate Anticoagulation Protocols for CVVH, CVVHDF and SLED Focused on the Prevention of RRT-related Hypophosphatemia and Optimization of Acid-base Balance: a Pilot Study
Citrate Versus Heparin in Continuous Renal Replacement Therapy : Effect on Cardiovascular System and Clot Circuit in Critically Ill Patients
Who cites it
63 citing papers in PubMed, 3 syntheses or guidelines pooled it, 164 citations in OpenAlex.
- Regional Citrate Anticoagulation Versus Systemic Heparin in Continuous Kidney Replacement Therapy: Examining the Role of Evidence in Health Technology Assessment.Advances in therapy · 2025Pooled it
- Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials.Critical care (London, England) · 2023Pooled it
- Management of regional citrate anticoagulation for continuous renal replacement therapy: guideline recommendations from Chinese emergency medical doctor consensus.Military Medical Research · 2023Guideline
- Trial
- Efficacy and safety of citrate-based anticoagulation compared to heparin in patients with acute kidney injury requiring continuous renal replacement therapy: a randomized controlled trial.Critical care (London, England) · 2015Trial
- Implementation quality as a modifiable determinant of filter lifespan in regional citrate anticoagulation: a real-world clustering-adjusted study.Renal failure · 2026Article
- Ethylene Glycol Poisoning Without Fomepizole in a Regional Australian Intensive Care Unit: The Lactate Gap as the Diagnostic Key and the Consequences of Nasogastric Ethanol Therapy.Clinical case reports · 2026Article
- Article
- Metabolic complications of citrate anticoagulation in continuous renal replacement therapy (crrt): a delphi consensus on indications, monitoring and management.Critical care (London, England) · 2026Review
- Troubleshooting Ionized Hypocalcemia in Patients on Continuous KRT with Regional Citrate Anticoagulation.Kidney360 · 2026Review
- Article
- Beyond renal support: biological modulation across pathophysiological domains during continuous renal replacement therapy - a randomized pilot study.Frontiers in nephrology · 2026Article
- Regional citrate anticoagulation for renal replacement therapy during venovenous ECMO: A randomized crossover pilot study.Annals of intensive care · 2026Article
- Renal replacement therapy in intensive care unit: a narrative review.Annals of intensive care · 2026Review
- Regional citrate anticoagulation ensures safe and effective kidney replacement therapy in metformin-associated lactic acidosis.Clinical kidney journal · 2025Article
- Regional citrate anticoagulation for intermittent renal replacement therapy in critically ill patients: a retrospective case-control study.BMC nephrology · 2025Article
- Regional citrate anticoagulation for continuous renal replacement therapy: a prospective study in a resource-limited intensive care unit from Vietnam.Journal of nephrology · 2025Article
- The Application of Regional Citrate Anticoagulation in Protein A Immunoadsorption: A Single-Center Retrospective Cohort Study.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2024Article
- Quality indicators in prolonged hemodialysis with regional citrate anticoagulation with the genius system: retrospective cohort of critical patients with acute kidney injury.BMC nephrology · 2023Article
- Hypercitratemia is a mortality predictor among patients on continuous venovenous hemodiafiltration and regional citrate anticoagulation.Scientific reports · 2023Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hemorrhagic complications have been reported in up to 30% of critically ill patients with AKI undergoing RRT with systemic anticoagulation. Because bleeding is associated with significantly increased mortality risk, strategies aimed at reducing hemorrhagic complications while maintaining extracorporeal circulation should be implemented. Among the alternatives to systemic anticoagulation, regional citrate anticoagulation has been shown to prolong circuit life while reducing the incidence of hemorrhagic complications and lowering transfusion needs. For these reasons, the recently published Kidney Disease Improving Global Outcomes Clinical Practice Guidelines for Acute Kidney Injury have recommended regional citrate anticoagulation as the preferred anticoagulation modality for continuous RRT in critically ill patients in whom it is not contraindicated. However, the use of regional citrate anticoagulation is still limited because of concerns related to the risk of metabolic complications, the complexity of the proposed protocols, and the need for customized solutions. The introduction of simplified anticoagulation protocols based on citrate and the development of dialysis monitors with integrated infusion systems and dedicated software could lead to the wider use of regional citrate anticoagulation in upcoming years.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.