SynthesisFrontiers in medicine2025
Citrate as a safe and effective alternative to heparin for catheter locking: a systematic review and meta-analysis of randomized controlled trials.
Synthesis in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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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
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of different antibiotic lock solutions on catheter-related infections of hemodialysis patients: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Comparative efficacy of low-concentration trisodium citrate and low-concentration heparin for locking central venous hemodialysis catheters: a randomized controlled study.Renal failure · 2026Trial
- Comparable rates of catheter-related bloodstream infections between non-tunneled and tunneled hemodialysis catheters: a retrospective single-center study.Clinical kidney journal · 2026Article
- Antimicrobial Effect of Gentamicin/Heparin and Gentamicin/Citrate Lock Solutions onInfectious disease reports · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Consensus on the use of citrate vs.heparin for catheter locking remains elusive, with ongoing controversy. This meta-analysis investigates the efficacy and safety of citrate lock solutions compared to heparin lock solutions in preventing catheter-related complications. Methods: The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers conducted literature searches based on preferred reporting items from systematic reviews and meta-analyses. PubMed, EMBASE, Medline, and the Cochrane Library were searched for studies comparing citrate and heparin in patients with catheter. Catheter-related bloodstream infection (CRBSI), catheter-related infection (CRI), exit-site infection (ESI), and adverse events were analyzed. Results: The meta-analysis included 17 randomized controlled trials (RCTs), encompassing 247,431 catheter-days, with 128,904 in the citrate group, and 118,527 in the heparin group. Citrate lock solutions significantly reduced the incidence of CRBSI compared to heparin (RR: 0.48, 95% CI: 0.31-0.73), particularly when combined with antibiotics or used at low concentrations. No significant differences were observed between the groups for CRI, ESI, catheter dysfunction, or local bleeding. Subgroup and sensitivity analyses addressed heterogeneity, confirming the robustness of the primary findings. Conclusions: Citrate lock solutions effectively prevent CRBSI without increasing systemic coagulation dysfunction or bleeding risk. Citrate lock solutions are a safe and effective alternative to heparin, especially when combined with antibiotics. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024562511.
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Registered trials
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.