ArticlePediatric nephrology (Berlin, Germany)2017
Citrate versus heparin anticoagulation in continuous renal replacement therapy in small children.
Article in Pediatric nephrology (Berlin, Germany), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 45 citations in OpenAlex.
- Neonatal continuous kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2026Review
- Safety and efficacy of low-dose initial citrate infusion for continuous kidney replacement therapy in critically ill children.Pediatric nephrology (Berlin, Germany) · 2026Article
- Renal replacement therapy in intensive care unit: a narrative review.Annals of intensive care · 2026Review
- Renal replacement therapy in an intensive care unit: guidelines from the SRLF-GFRUP consensus conference.Annals of intensive care · 2025Review
- Evaluation of anticoagulant methods in newborns undergoing continuous renal replacement therapy: what is the optimum method?European journal of pediatrics · 2025Article
- Effect of sodium citrate anticoagulant solution in continuous veno-venous hemofiltration in critically ill children.BMC pediatrics · 2025Article
- Effective management of pediatric septic shock: a case study utilizing continuous renal replacement therapy with cytosorb and citrate in a leukemic patient with hyper-interleukin (IL)-6-naemia and severe thrombocytopenia.BMC infectious diseases · 2025Article
- Provision of continuous renal replacement therapy in children in intensive care in Australia and New Zealand.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2024Article
- Factors influencing circuit lifetime in paediatric continuous kidney replacement therapies - results from the EurAKId registry.Pediatric nephrology (Berlin, Germany) · 2024Observational
- Citrate anticoagulation and systemic heparin anticoagulation during continuous renal replacement therapy among critically-ill children.Pediatric research · 2024Article
- Continuous renal replacement therapy in neonates and children: what does the pediatrician need to know? An overview from the Critical Care Nephrology Section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC).European journal of pediatrics · 2024Review
- Evaluation of the efficacy and associated complications of regional citrate anticoagulation in neonates: experience from a fourth level neonatal intensive care unit.European journal of pediatrics · 2023Article
- Clinical characteristics and outcomes of continuous renal replacement therapy performed on younger children weighing up to 10 kg.Turkish journal of medical sciences · 2023Observational
- Novel blood product transfusion regimen to prevent clotting and citrate accumulation during continuous renal replacement therapy with regional citrate anticoagulation in children.Frontiers in pediatrics · 2023Article
- Regional citrate anticoagulation for continuous renal replacement therapy in newborns.Frontiers in pediatrics · 2023Article
- Clinical application of regional citrate anticoagulation for membrane-based therapeutic plasma exchange in children with liver failure.Frontiers in pediatrics · 2023Article
- Continuous Kidney Replacement Therapy Practices in Pediatric Intensive Care Units Across Europe.JAMA network open · 2022Article
- Anticoagulation strategies in continuous kidney replacement therapy - does one size fit all?Pediatric nephrology (Berlin, Germany) · 2022Article
- Anticoagulation in patients with acute kidney injury undergoing kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2022Article
- Regional Citrate Anticoagulation and Systemic Anticoagulation during Pediatric Continuous Renal Replacement Therapy: A Systematic Literature Review.Journal of clinical medicine · 2022Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCitrate is preferred over heparin as an anticoagulant in adult continuous renal replacement therapy (CRRT). However, its potential adverse effects and data on use in CRRT in infants and toddlers is limited. We conducted a prospective study on using citrate in CRRT in critically ill small children.
methodsChildren who underwent CRRT with the smallest filter in our PICU between November 2011 and November 2016 were included. Both heparin and citrate were applied according to a strict protocol. Our primary outcome was circuit survival time. Secondary outcomes were alkalosis, citrate toxicity, and number of red blood cell transfusions.
resultsHeparin was used in six patients (121 circuits, total CRRT time 3723 h). Citrate was used in 14 patients (105 circuits, total CRRT time 4530 h). Median circuit survival time with heparin was 21 h (IQR 14.5-27.5) compared to 45.2 h (IQR 37.5-52.8) with citrate (p < 0.001). Actual administered effluent dose compared to prescribed dose was 85% (IQR 69-98%) with heparin compared to 92% (IQR 88-98%) with citrate (p = 0.31). No patient treated with citrate developed citrate toxicity. No other differences in electrolytes were found between the two CRRT regimes. In the heparin group, a median of 6.5 units of red blood cells (IQR 1.5-23.8) were given during CRRT, compared to three in the citrate group (IQR 2.0-5.0, p = 0.12).
conclusionsUse of regional citrate significantly prolongs circuit survival time and thereby should increase CRRT efficiency when compared to heparin. In addition, citrate appears safe for CRRT in critically ill small children.
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