Evidence map›Paper›PMID 39189201›Full record

Trial reportMedical sciences (Basel, Switzerland)2024

Hemodialysis without Systemic Anticoagulation: A Randomized Controlled Trial to Evaluate Five Strategies in Patients at a High Risk of Bleeding.

Pedro H Franca Gois, David McIntyre, Sharad Ratanjee, Anita Pelecanos, Carla Scuderi, Chungun L Janoschka, Kara Summers, Haibing Wu, Belinda Elford, Dwarakanathan Ranganathan and 1 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Medical sciences (Basel, Switzerland), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Observational
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

11 authors.

Pedro H Franca GoisKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.ORCID 0000-0002-3520-3225
David McIntyreNephrology Department, Townsville University Hospital, Douglas, QLD 4814, Australia.ORCID 0000-0002-6830-0582
Sharad RatanjeeKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.ORCID 0000-0002-6024-7684
Anita PelecanosStatistics Unit, QIMR Berghofer Medical Research Institute, Herston, QLD 4006, Australia.
Carla ScuderiKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
Chungun L JanoschkaKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
Kara SummersKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
Haibing WuKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
Belinda ElfordKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.
Dwarakanathan RanganathanKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.ORCID 0000-0003-1215-1773
Helen G HealyKidney Health Service, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia.ORCID 0000-0003-4342-5300

Funding

RBWH Foundation Grant EC00172
6 · The paper itself

Abstract

backgroundThere has been growing interest in exploring combined interventions to achieve a more effective heparin-free treatment approach.

aimto evaluate combination of interventions compared to standard practice (intermittent flushes) to prevent clotting and consequently reduce premature interruptions of hemodialysis.

methodsThis open-label randomized controlled trial recruited chronic hemodialysis patients with contra-indication to systemic heparinization. Participants were randomized into one of five groups to receive different strategies of heparin-free hemodialysis treatment for up to three sessions. PRIMARY ENDPOINT: the successful completion of hemodialysis without clotting. SECONDARY OUTCOMES: the clotting of the air traps assessed by a semi-quantitative scale, online KT/V, and safety of the interventions.

resultsForty participants were recruited and randomized between May and December 2020. Participants showed similar baseline biochemistry results and coagulation profiles. The highest success rates were observed in group 3 (heparin-coated dialyzers combined with intermittent flushes) (100%) and group 5 (hemodiafiltration with online predilution combined with heparin-coated dialyzers), with 91% vs. the control (intermittent flushes) (64%). Group 2 (heparin-coated dialyzers alone) had the poorest success rate, with 38% of the sessions being prematurely terminated due to clotting. KT/V and clotting scores were similar between groups. No adverse events related to the trial interventions were observed.

conclusionsThe proposed combination of interventions may have had additive effects, leading to less frequent clotting and the premature termination of an HD/HDF session. Our study supports the feasibility of conducting a larger randomized controlled trial focusing on the efficacy of combined interventions for heparin-free HD in patients with a high risk of bleeding.

Indexed as

AnticoagulantsHemorrhageHeparinRenal DialysisAgedBlood CoagulationFemaleHumansMaleMiddle AgedAnticoagulantsHeparinanticoagulationHemodialysisheparin-coated dialyzerheparin-freeintermittent saline flushesrandomized controlled trial

Identifiers

PMID39189201
PMCPMC11348230

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.