|
|
Comparative Analysis of the Effect of Local Citrate Anticoagulation and Non-anticoagulation in Extended Intermittent Renal Replacement Therapy (PIRRT) |
FU Bi-ling, SHEN Xun, LIU Ying-shan, ZHANG Ai-sha, ZHOU Li, CHEN Ji-hong* |
Department of Nephrology, Shenzhen Bao'an District People's Hospital, Shenzhen Guangdong 518101, China |
|
|
Abstract Objective: To observe the anticoagulant effect of local citrate anticoagulation and non-anticoagulation in prolonged intermittent renal replacement therapy (PITTR). Methods: From October 2018 to October 2019, 30 patients with a high risk of bleeding who received PIRRT treatment in our hospital were selected and divided into RCA group (citrate group) and control group (non-anticoagulant group), 15 cases in each group. The anticoagulant efficiency, filter service life, coagulation function, and blood gas indexes were compared between the two groups. Results: (1) the anticoagulant effective rate of the RCA group was higher than that of the control group, and the use time of the filter was longer than that of the control group(P<0.05). (2) There was no significant difference in Pt and APTT between the two groups before and after treatment (P>0.05). (3) There was no significant difference in plasma calcium concentration between the two groups before treatment, 4, 6 and 8 h after treatment (P>0.05). (4) In the RCA group, the pH value and be valued at 4, 6 and 8 h after treatment were higher than those before treatment, but they were in the normal range, and the difference was statistically significant (P<0.05). Conclusion: In the extended intermittent renal replacement therapy, the effect of local citrate anticoagulation is better than that of non-anticoagulant therapy, which can prolong the service life of the filter, and there are no adverse reactions such as prolonged coagulation time, hypocalcemia, and metabolic acid-base imbalance.
|
Received: 12 December 2020
|
Corresponding Authors:
CHEN Ji-hong. E-mail: fubiling66@163.com
|
|
|
|
[1] Fathima N, Kashif T, Janapala RN, et al.Single-best choice between intermittent versus continuous renal replacement therapy:A review[J]. Cureus, 2019, 11(9):e5558. [2] Edrees F, Li T, Vijayan A.Prolonged intermittent renal replacement therapy[J]. Adv Chronic Kidney Dis, 2016, 23(3):195-202. [3] Neves JB, Rodrigues FB, Castel OM.Extended daily dialysis versus intermittent hemodialysis for acute kidney injury:A systematic review[J]. J Crit Care, 2016, 33:271-273. [4] Kielstein JT, Schiffer M, Hafer C.Back to the future:extended dialysis for treatment of acute kidney injury in the intensive care unit[J]. J Nephrol, 2010, 23:494-501. [5] Nongnuch A, Tangsujaritvijit V, Davenport A.Anticoagulation for renal replacement therapy for patients with Acute Kidney Injury[J]. Minerva Urol Nefrol, 2016, 68(1):87-104. [6] Tao Y, Hu W.Comparative study of chronic renal failure patients' efficacy between sustained low-efficiency daily dialysis(SLEDD)and intermittent hemodialysis(IHD)[J]. Hong Kong J Nephrol, 2015, 17(2):S130. [7] Yang Songtao, Ding Qiuling, Li Bin, et al.Comparison of application of different anticoagulant techniques in the implementation of continuous renal replacement therapy in critically ill patients[J]. Journal of Sino Japanese Friendship Hospital, 2014, 28(4): 208-211. [8] Zhang Yan, Wang Yingjie, Xu Tao.Application of citrate anticoagulation and heparin anticoagulation in continuous renal replacement therapy for severe patients[J]. Medical Theory and Practice, 2019,32(12): 1804-1806. [9] Yang Songtao, Zhao Na, Hu Jun, et al.Clinical observation of topical citrate anticoagulant hemodialysis with ordinary calcium containing dialysate[J]. China Blood Purification, 2017,16(7): 474. [10] Francey T, Schweighauser A.Regional citrate anticoagulation for intermittent hemodialysis in dogs[J]. J Vet Intern Med, 2018, 32:147-156. [11] Stoker F, Prote B, Tataw J, et al.Efficacy and safety of citrate-based anticoagulation compared to heparin in patients with actue kidney injury requiring continuous renal replacement therapy:a randomized controlled trial[J]. Crit Care, 2015, 19:51. [12] Gattas DJ, Rajbhandari D, Bradford C, et al.A randomized controlled trail of regional citrate versus regional heparin anticoagulation for continuous renal replacement threapy in critically ILL adults[J]. Crit Care Med, 2015, 43(8):1622-1629. [13] Khwaja A.KDIGO clinical practice guidelines for acute kidney injury[J]. Nephron Clin Pract, 2012, 120(4):c179. [14] Dai Xuemei, Guo Xiaojuan, Dou Yingru, et al.Effect of normal saline irrigation on the service life of CRRT filter in patients with citrate anticoagulant therapy[J]. Qilu Journal of Nursing, 2017, 23(16): 98-100. [15] Akhoundi A, Singh B, Vela M, et al.Incidence of adverse events during continuous renal replacement therapy[J]. Blood Purif, 2015, 39:333-339. [16] Anatsui, Tina C, Adekanye, et al. Comparative analysis of foreign and local news agencies: public relations approach in restoring the image of the local media for national development[J]. Career Horizon, 2014, 633-634(6):1104-1110. [17] Wang Tingli, Zhang Ling, Chen Zhiwen, et al.Evaluation of the application of regional citrate anticoagulation in sustained low efficiency hemodialysis[J]. Zhonghua N Ke Za Zhi, 2014, 53(12):953. [18] Vong LV, Osman D, Vinsonneau C.Renal replacement therapy adult and children intensive care unit[J]. Réanimation, 2014, 23(6):714-737. [19] Liu Wenyue, Wei Xiaohua, Yang Lili, et al.Comparative study of local citrate anticoagulation and systemic heparin anticoagulation in the treatment of acute renal injury in sepsis patients with CRRT[J]. Medical Journal of West China, 2018. Comparative study of local citrate anticoagulation and systemic heparin anticoagulation in the treatment of acute renal injury in sepsis patients with CRRT[J]. Medical Journal of West China, 2018. http://www.en.cnki.com.cn/Article_en/CJFDTotal-XIBU201802013.htm. [20] Chen Keshu, Lin Junying, Che Jialian, et al.Comparative analysis of the effects of citrate anticoagulation and systemic heparinized anticoagulation in patients with acute renal injury with sepsis[J]. China & Foreign Medical Treatment, 2019. Comparative analysis of the effects of citrate anticoagulation and systemic heparinized anticoagulation in patients with acute renal injury with sepsis[J]. China & Foreign Medical Treatment, 2019. http://en.cnki.com.cn/Article_en/CJFDTotal-HZZZ201931023.htm. |
|
|
|