ArticleScientific reports2022
Citrate pharmacokinetics in critically ill liver failure patients receiving CRRT.
Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Regional Citrate Anticoagulation Versus No Anticoagulation During Continuous Renal Replacement Therapy in Critically Ill Patients at High Risk of Bleeding: A Meta-analysis of Randomized Controlled Trials.Advances in therapy · 2026Pooled it
- Management of regional citrate anticoagulation for continuous renal replacement therapy: guideline recommendations from Chinese emergency medical doctor consensus.Military Medical Research · 2023Guideline
- Regional Citrate Anticoagulation or Heparin Anticoagulation for Renal Replacement Therapy in Patients With Liver Failure: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- A safe and effective protocol for postdilution hemofiltration with regional citrate anticoagulation.BMC nephrology · 2024Trial
- Evaluating the Whole Blood Survival Advantage: How Citrate and Calcium Levels Drive Mortality in a Translational Swine Model of Polytrauma.Journal of the American College of Emergency Physicians open · 2026Article
- Systemic Citrate Toxicity During Regional Citrate Anticoagulation for Continuous Kidney Replacement Therapy.Journal of clinical medicine · 2026Review
- Prevalence of bone mineral disease in children with acute kidney disease on continuous kidney replacement therapy: a case-control study.Pediatric nephrology (Berlin, Germany) · 2026Article
- Troubleshooting Ionized Hypocalcemia in Patients on Continuous KRT with Regional Citrate Anticoagulation.Kidney360 · 2026Review
- Article
- Dose response of nafamostat mesylate for anticoagulation monitoring in pediatric critical care during continuous venovenous hemodiafiltration.Scientific reports · 2025Article
- Incidence, severity, and predictors of citrate accumulation during continuous kidney replacement therapy in the critically ill.Critical care (London, England) · 2025Article
- Clinical and biological profiles associated with the time of occurrence of citrate accumulation in patients receiving continuous renal replacement therapy.Critical care (London, England) · 2025Observational
- Article
- Continuous renal replacement therapy and therapeutic plasma exchange in pediatric liver failure.European journal of pediatrics · 2024Article
- Article
- Impact of Transfused Citrate on Pathophysiology in Massive Transfusion.Critical care explorations · 2023Review
- Evaluation of the registry DIALYREG for the assessment of continuous renal replacement techniques in the critically ill patient.Scientific reports · 2023Article
- A study of citrate and bivalirudin for anticoagulation during continuous renal replacement therapy in critically ill patients with acute kidney injury.Saudi journal of anaesthesiaArticle
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Citrate has been proposed as anticoagulation of choice in continuous renal replacement therapy (CRRT). However, little is known about the pharmacokinetics (PK) and metabolism of citrate in liver failure patients who require CRRT with regional citrate anticoagulation (RCA). This prospective clinical PK study was conducted at King Chulalongkorn Memorial Hospital between July 2019 to April 2021, evaluating seven acute liver failure (ALF) and seven acute-on-chronic liver failure (ACLF) patients who received CRRT support utilizing RCA as an anticoagulant at a citrate dose of 3 mmol/L. For evaluation of the citrate PK, we delivered citrate for 120 min and then stopped for a further 120 min. Total body clearance of citrate was 152.5 ± 50.9 and 195.6 ± 174.3 mL/min in ALF and ACLF, respectively. The ionized calcium, ionized magnesium, and pH slightly decreased after starting citrate infusion and gradually increased to baseline after stopping citrate infusion. Two of the ACLF patients displayed citrate toxicity during citrate infusion, while, no ALF patient had citrate toxicity. In summary, citrate clearance was significantly decreased in critically ill ALF and ACLF patients receiving CRRT. Citrate use as an anticoagulation in these patients is of concern for the risk of citrate toxicity.
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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.