ReviewJournal of anesthesia, analgesia and critical care2023
Regional citrate anticoagulation (RCA) in critically ill patients undergoing renal replacement therapy (RRT): expert opinion from the SIAARTI-SIN joint commission.
Review in Journal of anesthesia, analgesia and critical care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 4 of them syntheses that pooled it.
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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.
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Who cites it
21 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- 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
- 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
- Extracorporeal Blood Purification with the oXiris® Filter for Patients with Sepsis and Hyperinflammatory Conditions: The Asia-Pacific oXiris Expert Meeting 2024 Consensus Statements.Blood purification · 2025Guideline
- Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis.Renal failure · 2024Pooled it
- Complications and outcomes of children under one year treated with continuous kidney replacement therapy.Pediatric nephrology (Berlin, Germany) · 2026Observational
- Article
- Systemic Citrate Toxicity During Regional Citrate Anticoagulation for Continuous Kidney Replacement Therapy.Journal of clinical medicine · 2026Review
- The Safety of Pre-Filter Heparin for Circuit Clotting Prevention in Continuous Renal Replacement Therapy: A Retrospective Evaluation.Journal of clinical medicine · 2026Article
- Regional citrate anticoagulation for renal replacement therapy during venovenous ECMO: A randomized crossover pilot study.Annals of intensive care · 2026Article
- Incidence, severity, and predictors of citrate accumulation during continuous kidney replacement therapy in the critically ill.Critical care (London, England) · 2025Article
- Regional citrate anticoagulation ensures safe and effective kidney replacement therapy in metformin-associated lactic acidosis.Clinical kidney journal · 2025Article
- Edge computing with federated learning for early detection of citric acid overdose and adjustment of regional citrate anticoagulation.BMC medical informatics and decision making · 2025Article
- Regional citrate anticoagulation algorithm and management protocol aimed at ensuring blood calcium stability: a prospective single-arm study.Clinical kidney journal · 2025Article
- Antimicrobial Dosing During Continuous Venovenous Hemodiafiltration in Septic Shock Patients: A Prospective, Multicenter Study Protocol.Antibiotics (Basel, Switzerland) · 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
- Sustained Low-Efficiency Dialysis (SLED) with Regional Citrate Anticoagulation (RCA) and new dialysis equipment: a prospective study with serum citrate measurements and electrolyte monitoring.Journal of nephrology · 2025Article
- The role of extracorporeal COFrontiers in medicine · 2025Review
- Successful management of hypercalcemic crisis by continuous renal replacement therapy with regional citrate anticoagulation and surgery: a case report.Therapeutic advances in endocrinology and metabolism · 2025Article
- Optimizing Continuous Renal Replacement Therapy with Regional Citrate Anticoagulation: Insights from the ORCA Trial-A Retrospective Study on 10 Years of Practice.Life (Basel, Switzerland) · 2024Article
- Sustained low-efficiency dialysis with regional citrate anticoagulation is a suitable therapeutic option for refractory hypermagnesemia in critically ill patients with AKI.Journal of nephrology · 2024Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Renal replacement therapies (RRT) are essential to support critically ill patients with severe acute kidney injury (AKI), providing control of solutes, fluid balance and acid-base status. To maintain the patency of the extracorporeal circuit, minimizing downtime periods and blood losses due to filter clotting, an effective anticoagulation strategy is required.Regional citrate anticoagulation (RCA) has been introduced in clinical practice for continuous RRT (CRRT) in the early 1990s and has had a progressively wider acceptance in parallel to the development of simplified systems and safe protocols. Main guidelines on AKI support the use of RCA as the first line anticoagulation strategy during CRRT in patients without contraindications to citrate and regardless of the patient's bleeding risk.Experts from the SIAARTI-SIN joint commission have prepared this position statement which discusses the use of RCA in different RRT modalities also in combination with other extracorporeal organ support systems. Furthermore, advise is provided on potential limitations to the use of RCA in high-risk patients with particular attention to the need for a rigorous monitoring in complex clinical settings. Finally, the main findings about the prospective of optimization of RRT solutions aimed at preventing electrolyte derangements during RCA are discussed in detail.
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