Evidence map›Paper›PMID 34777842›Full record

ArticleCanadian journal of kidney health and disease2021

Regional Hypertonic Citrate Anticoagulation in Membrane Therapeutic Plasma Exchange: A Case Series.

Thiago Reis, Geraldo Rubens Ramos de Freitas, Fábio Reis, Maria Letícia Cascelli de Azevedo, Priscila Dias, Diêgo Fernando Figueiredo Santos, Rodrigo Alfredo Vivanco Vergara, Luca Sgarabotto, Evandro Reis da Silva Filho, Claudio Ronco

Open access · goldAbstract read
In one paragraph

Article in Canadian journal of kidney health and disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 38% of its field
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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
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

10 authors at 3 institutions in 2 countries.

Thiago ReisLaboratory of Molecular Pharmacology, University of Brasília, Brazil.ORCID https://orcid.org/0000-0002-7071-117X
Geraldo Rubens Ramos de FreitasDepartment of Nephrology, Clínica de Doenças Renais de Brasília, Brazil.
Fábio ReisDepartment of Nephrology, Clínica de Doenças Renais de Brasília, Brazil.
Maria Letícia Cascelli de AzevedoDepartment of Nephrology, Clínica de Doenças Renais de Brasília, Brazil.
Priscila DiasDepartment of Nephrology, Clínica de Doenças Renais de Brasília, Brazil.
Diêgo Fernando Figueiredo SantosDepartment of Nephrology, Clínica de Doenças Renais de Brasília, Brazil.
Rodrigo Alfredo Vivanco VergaraDepartment of Nephrology, Clínica de Doenças Renais de Brasília, Brazil.
Luca SgarabottoDepartment of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.
Evandro Reis da Silva FilhoDepartment of Nephrology, Clínica de Doenças Renais de Brasília, Brazil.
Claudio RoncoDepartment of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza, San Bortolo Hospital, Vicenza, Italy.
Clinica De Doencas Renais De Brasilia · BRUniversity of Padua · ITUniversidade de Brasília · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleProtocols for regional citrate anticoagulation with the hypertonic 4% trisodium citrate solution have been recently described as an anticoagulation strategy during membrane therapeutic plasma exchange (mTPE). The effect of citrate in the patient's systemic hemostasis is negligible, thus regional citrate anticoagulation application is advantageous in circumstances in which heparin-based protocols are deemed unsafe for patients with a high risk of bleeding. The downsides of using hypertonic citrate solutions are mainly hypocalcemia and hypernatremia that ultimately can cause adverse clinical events. PRESENTING CONCERNS OF THE PATIENT: (1) A 57-year-old Caucasian female with a history of active vaginal bleeding secondary to endometrial hyperplasia. She had a history of antiphospholipid syndrome, and systemic lupus erythematosus with marked refractory autoimmune thrombocytopenia. Her platelet count was persistently below 4,000/mm DIAGNOSES: (1) Systemic lupus erythematosus-associated autoimmune thrombocytopenia and (2) ANCA-associated vasculitis with kidney and lung involvement.

interventionsHerein, we describe a case series of 12 consecutive mTPE treatments in 2 different patients using regional 4% trisodium citrate anticoagulation. OUTCOMES: All the sessions were uneventful, presented only minor electrolyte imbalances, and were effectively completed without early interruptions due to clotting of the plasmafilter. TEACHING POINTS: In our 2 cases, extracorporeal regional citrate anticoagulation was successful in optimizing plasmafilter patency without bleeding events in 2 high-risk patients using established protocols for the citrate and calcium infusions.

Indexed as

autoimmune diseasesplasmapheresisregional citrate anticoagulationtherapeutic plasma exchange

Identifiers

PMID34777842
PMCPMC8579339
OpenAlexW3214252953

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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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.