Advances in the application of regional citrate anticoagulation for continuous renal replacement therapy in patients with liver failure

• Published in: Zhonghua gan zang bing za zhi Vol. 26; no. 7; p. 549
• Main Authors: Ning, Q Q, Meng, Q H, Zhu, Y K
• Format: Journal Article
• Language: Chinese
• Published: China 20-07-2018
• Subjects: Acute Kidney Injury - therapy; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Citrates; Citric Acid - adverse effects; Citric Acid - therapeutic use; Humans; Liver Failure - drug therapy; Liver Failure - metabolism; Renal Replacement Therapy - adverse effects; Citrate anticoagulation; Liver failure; Renal replacement therapy
• ISSN: 1007-3418
• DOI: 10.3760/cma.j.issn.1007-3418.2018.07.015

Currently, continuous renal replacement therapy (CRRT) is one of the most important means of organ support methods in critical care medicine. Anticoagulation is an essential part of the treatment process due to its prolonged duration. Patients with liver failure often have coagulation dysfunction and heparin anticoagulant can increase the risk of bleeding, but without heparin anticoagulant, coagulation can easily occur. In addition, an increased volumetric load, hemodynamic instability, nursing workload and other problems are major issues. Therefore, regional citrate anticoagulation (RCA) is the main anticoagulant method for CRRT therapy in patients with liver failure. This article reviews the mechanism, indications, advantages and disadvantages of using RCA to CRRT in hepatic failure.