Regional citrate anticoagulation-CRRT with Calcium-Containing Solution Found Safe and Effective: Study
A new study published in BMC Nephrology has demonstrated that regional citrate anticoagulation continuous renal replacement therapy (RCA-CRRT) using a calcium-containing replacement solution is both safe and effective for critically ill patients requiring renal support. The researchers found that this approach maintained effective anticoagulation while reducing complications related to calcium imbalance. Among the different continuous renal replacement therapy modalities evaluated, continuous veno-venous hemodiafiltration (CVVHDF) showed longer filter survival, suggesting it may be the most efficient option in clinical use.
According to the authors, conventional RCA-CRRT protocols often rely on calcium-free replacement fluids, which can lead to complex calcium monitoring and supplementation requirements. In contrast, the calcium-containing solution simplifies clinical management by maintaining stable calcium levels without compromising anticoagulation efficacy. The study noted that this modified protocol ensured adequate circuit patency, stable acid-base balance, and consistent electrolyte control throughout treatment, without a rise in citrate-related side effects or metabolic complications.
The researchers concluded that the use of calcium-containing solutions in RCA-CRRT represents a promising evolution in renal replacement therapy protocols. This method may improve workflow efficiency in intensive care settings by reducing the need for frequent adjustments and laboratory monitoring. They recommended further multicenter studies to validate these findings across diverse patient populations and to establish standardized guidelines for clinical implementation. Overall, this study provides strong evidence supporting RCA-CRRT with calcium-containing solutions as a practical and safe alternative for managing critically ill patients with acute kidney injury.
Keywords: regional citrate anticoagulation, continuous renal replacement therapy, calcium-containing solution, hemodiafiltration, filter survival, BMC Nephrology
