Utility of Citrate Dialysis in Patients with Contraindication for Heparin in a Limited-Resource Setting
| Author | Rajaram Jagdale | en |
| Author | Alan Almeida | en |
| Author | Jatin Kothari | en |
| Author | Rasika Sirsat | en |
| Author | Supriya Surwase | en |
| Author | Dixon Thomas | en |
| Issued Date | 2022-08-31 | en |
| Abstract | Background: Hemodialysis among critical care patients with acute kidney injury (AKI) is challenging, especially if heparin is contraindicated. Objectives: This study assessed the utility of citrate dialysis for such patients in a limited-resource setting. Methods: In this prospective study, patients were divided into group A (heparin-free saline flush dialysis), group B (heparin-free citrate dialysis without flushing), and group C (heparin-free citrate dialysis with flushing). The subjects underwent completed sustained low-efficiency daily dialysis (blood flow = 150 mL/minute, dialysate = 300 mL/minute) or intermittent hemodialysis (blood flow = 250 mL/minute, dialysate flow = 500 mL/minute). Statistical tests using SPSS software (version 26) were used to determine safety and effectiveness differences. Results: Among 25 patients studied with multiple hemodialysis sessions, blood flow and dialysate flow were observed to be better in heparin-free citrate dialysis with flushing. There were further advantages of lesser dialyzer clotting and more reuse of dialyzers. Metabolic differences were insignificant. Heparin-free citrate dialysis with or without flushing was equally effective and safe, compared to heparin-free saline flush dialysis, in patients with or without liver impairment. Conclusions: Citrate dialysis is observed to be a safe and effective alternative to heparin-free saline flushing dialysis in intensive care unit patients with AKI. More such studies are required in limited-resource settings to utilize citrate dialysis in patients with heparin contraindication. | en |
| DOI | https://doi.org/10.5812/numonthly-124164 | en |
| URI | https://brieflands.com/journals/num/articles/124164 | en |
| Keyword | Citrate Dialysis | en |
| Keyword | Heparin Contraindication | en |
| Keyword | Bleeding | en |
| Keyword | Acute Kidney Injury | en |
| Publisher | Brieflands | en |
| Title | Utility of Citrate Dialysis in Patients with Contraindication for Heparin in a Limited-Resource Setting | en |
| Type | Research Article | en |
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