Lohr J W, Slusher S, Diederich D
Department of Medicine, University of Kansas Medical Center, Kansas City.
Am J Kidney Dis. 1989 Feb;13(2):104-7. doi: 10.1016/s0272-6386(89)80126-x.
Regional citrate anticoagulation is an alternative to heparin anticoagulation for hemodialysis of patients at increased risk of bleeding. We report the successful use of this technique in 326 dialyses in 49 high bleeding risk patients with acute renal failure. Systemic anticoagulation did not occur as a result of any dialysis procedure, and in no instance was bleeding observed. Dialysis was effective, as judged by removal of creatinine. The safety of this procedure is demonstrated by the lack of bleeding complications and the small incidence of electrolyte and acid-base abnormalities. In addition we document the absence of citrate intoxication by serial measurements of serum citrate levels. Regional citrate anticoagulation is a safe and effective method of performing hemodialysis in patients with acute renal failure at increased risk of bleeding.
对于出血风险增加的患者，局部枸橼酸盐抗凝是血液透析中肝素抗凝的一种替代方法。我们报告了该技术在49例急性肾衰竭高出血风险患者的326次透析中的成功应用。由于任何透析程序均未发生全身抗凝，且未观察到出血情况。根据肌酐清除情况判断，透析是有效的。该程序的安全性体现在缺乏出血并发症以及电解质和酸碱异常的发生率较低。此外，我们通过连续测量血清枸橼酸盐水平证明不存在枸橼酸盐中毒。局部枸橼酸盐抗凝是对急性肾衰竭出血风险增加患者进行血液透析的一种安全有效的方法。
