Citrate Anticoagulation for Postdilution Hemofiltration

Citrate Anticoagulation for Postdilution Hemofiltration

This study evaluates a protocol for regional citrate anticoagulation in critically ill patients with acute kidney injury who are treated with continuous veno-venous haemofiltration in postdilution mode.

Acute kidney injury (AKI) requiring continuous renal replacement therapy (CCRT occurs in approx. 15 % of all intensive care patients. A sustained and prolonged filter running time is required to deliver an effective dialysis dose. This requires effective anticoagulation. Today, regional citrate anticoagulation (RCA) is preferred over systemic anticoagulation because of prolonged filter lifetimes and less adverse effects.

We here study prospectively patients with AKI who are treated with continuous veno-venous haemofiltration using an RCA protocol.

We will evaluate all parameters of CRRT including filter running times, delivered dialysis dose, causes for treatment interruption and control of pH and electrolytes.

Inclusion Criteria:

• acute kidney injury
• critical illness and treatment at ICU

Exclusion Criteria:

• age < 18 years
• pregnancy or breast feeding
• severe lactate acidosis ( > 10 mmol/l) for longer than 6 hours and pH < 7.2