Trial reportJournal of Zhejiang University. Science. B2022
Application of regional citrate anticoagulation in patients at high risk of bleeding during intermittent hemodialysis: a prospective multicenter randomized controlled trial.
Trial report in Journal of Zhejiang University. Science. B, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Anticoagulation for people receiving long-term haemodialysis.The Cochrane database of systematic reviews · 2024Pooled it
- Comparison of citrate anticoagulation strategies in hemodialysis patients at high risk of bleeding: a prospective observational cohort study.Renal failure · 2026Observational
- Article
- Renal replacement therapy in intensive care unit: a narrative review.Annals of intensive care · 2026Review
- Nafamostat mesylate versus regional citrate anticoagulation for chronic hemodialysis in patients at high risk of bleeding: a single-center, retrospective study.Renal failure · 2025Article
- Regional citrate anticoagulation for intermittent renal replacement therapy in critically ill patients: a retrospective case-control study.BMC nephrology · 2025Article
- Effect of sodium citrate anticoagulant solution in continuous veno-venous hemofiltration in critically ill children.BMC pediatrics · 2025Article
- Calcium-Free Dialysate Hemodialysis: A Simplified Approach.Journal of personalized medicine · 2024Article
- Hemodialysis bilayer bionic blood vessels developed by the mechanical stimulation of hepatitis B viral X(Journal of Zhejiang University. Science. B · 2024Article
- Risk factors for intracerebral hemorrhage in patients undergoing maintenance hemodialysis.Frontiers in neurology · 2023Article
- Development and validation of a predictive model for the assessment of potassium-lowering treatment among hyperkalemia patients.World journal of emergency medicine · 2023Article
Corrections and comments
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Authors and funding
26 authors at 12 institutions in 1 country.
Funding
Abstract
objectivesSafe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment.
methodsPatients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline.
resultsA total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%,
conclusionsCompared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
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