Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative review
Abstract The use of citrate, through reversible binding of calcium, has become the preferred choice for anticoagulation in continuous renal replacement therapy in the critically ill patient. Though generally considered as very efficacious in acute kidney injury, this type of anticoagulation can caus...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-03-01
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| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13613-023-01113-0 |
| _version_ | 1797863576394792960 |
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| author | Willem Boer Walter Verbrugghe Eric Hoste Rita Jacobs Philippe G. Jorens |
| author_facet | Willem Boer Walter Verbrugghe Eric Hoste Rita Jacobs Philippe G. Jorens |
| author_sort | Willem Boer |
| collection | DOAJ |
| description | Abstract The use of citrate, through reversible binding of calcium, has become the preferred choice for anticoagulation in continuous renal replacement therapy in the critically ill patient. Though generally considered as very efficacious in acute kidney injury, this type of anticoagulation can cause acid–base disorders as well as citrate accumulation and overload, phenomena which have been well described. The purpose of this narrative review is to provide an overview of some other, non-anticoagulation effects of citrate chelation during its use as anticoagulant. We highlight the effects seen on the calcium balance and hormonal status, phosphate and magnesium balance, as well as oxidative stress resulting from these unapparent effects. As most of these data on these non-anticoagulation effects have been obtained in small observational studies, new and larger studies documenting both short- and long-term effects should be undertaken. Subsequent future guidelines for citrate-based continuous renal replacement therapy should take not only the metabolic but also these unapparent effects into account. |
| first_indexed | 2024-04-09T22:38:48Z |
| format | Article |
| id | doaj.art-f632eb4cdf6b4c04bb116e76f5660edc |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-04-09T22:38:48Z |
| publishDate | 2023-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-f632eb4cdf6b4c04bb116e76f5660edc2023-03-22T12:22:16ZengSpringerOpenAnnals of Intensive Care2110-58202023-03-0113111010.1186/s13613-023-01113-0Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative reviewWillem Boer0Walter Verbrugghe1Eric Hoste2Rita Jacobs3Philippe G. Jorens4Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine & Pain Medicine, Ziekenhuis Oost Limburg ZOLDepartment of Critical Care Medicine, Antwerp University Hospital, University of AntwerpIntensive Care Unit, Department of Internal Medicine and Paediatrics, Ghent University Hospital, Ghent, and Research Foundation Flanders (FWO), Ghent UniversityDepartment of Critical Care Medicine, Antwerp University Hospital, University of AntwerpDepartment of Critical Care Medicine, Antwerp University Hospital, LEMP, University of AntwerpAbstract The use of citrate, through reversible binding of calcium, has become the preferred choice for anticoagulation in continuous renal replacement therapy in the critically ill patient. Though generally considered as very efficacious in acute kidney injury, this type of anticoagulation can cause acid–base disorders as well as citrate accumulation and overload, phenomena which have been well described. The purpose of this narrative review is to provide an overview of some other, non-anticoagulation effects of citrate chelation during its use as anticoagulant. We highlight the effects seen on the calcium balance and hormonal status, phosphate and magnesium balance, as well as oxidative stress resulting from these unapparent effects. As most of these data on these non-anticoagulation effects have been obtained in small observational studies, new and larger studies documenting both short- and long-term effects should be undertaken. Subsequent future guidelines for citrate-based continuous renal replacement therapy should take not only the metabolic but also these unapparent effects into account.https://doi.org/10.1186/s13613-023-01113-0Citrate anticoagulationCalcium balanceHormonesPhosphateMagnesiumReview |
| spellingShingle | Willem Boer Walter Verbrugghe Eric Hoste Rita Jacobs Philippe G. Jorens Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative review Annals of Intensive Care Citrate anticoagulation Calcium balance Hormones Phosphate Magnesium Review |
| title | Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative review |
| title_full | Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative review |
| title_fullStr | Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative review |
| title_full_unstemmed | Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative review |
| title_short | Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy: a narrative review |
| title_sort | unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review |
| topic | Citrate anticoagulation Calcium balance Hormones Phosphate Magnesium Review |
| url | https://doi.org/10.1186/s13613-023-01113-0 |
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