Aim: Regional citrate anticoagulation protocol for single-needle hemodialysis was tested prospectively for safety and efficacy.
Methods: 15 chronic dialysis patients at risk of bleeding were included. 4% trisodium citrate (200 ml/h), calcium-free dialysate and 1 mol/l calcium chloride (7 ml/h) were used. After dialysis the antithrombotic effect in the circuit was assessed visually (grade 5, no clotting, to 1, total occlusion) and serum citrate was measured.
Results: Of 32 dialyses performed, 94% were uneventful and in 2 cases (6%) there was severe (ionized calcium < or = 0.8 mmol/l) but asymptomatic hypocalcemia. Mean anticoagulation score after dialysis was 4.8 +/- 0.7 for the arterial bubble trap, 4.6 +/- 0.8 for the dialyzer and 4.8 +/- 0.7 for the venous bubble trap. Serum citrate after dialysis was 158 +/- 60 micromol/l.
Conclusion: Regional citrate anticoagulation in single-needle dialysis is safe and efficient.
2007 S. Karger AG, Basel