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Article Dans Une Revue Blood Purification Année : 2012

Safe Use of Citric Acid-Based Dialysate and Heparin Removal in Postdilution Online Hemodiafiltration

Julien Aniort
Caroline Créput
  • Fonction : Auteur

Résumé

Background: Anticoagulation of the blood circuit with heparin is essential for hemodialysis, but exposes patients to several risks (bleeding, thrombocytopenia, etc.). The use of citric acid-based dialysate (CitA-D) allows the reduction of heparin in conventional hemodialysis. We evaluated the feasibility of using CitA-D in postdilution online hemodiafiltration (OL-HDF) and of removing heparin. Methods: We prospectively compared chlorhydric acid-based dialysate with CitA-D in 10 patients treated by OL-HDF. First, we reduced heparin by half the dose and then we totally removed anticoagulation. Results: For all 120 sessions using heparin-free CitA-D, only one clotting episode related to an arteriovenous fistula stenosis was observed. No adverse clinical effect was observed. (Kt/V)sp, predialytic serum bicarbonate, calcium, phosphate, parathroid hormone, and β2-microglobulin remained the same in all cases. Conclusion: Our data suggest that the use of CitA-D in OL-HDF is safe and allows heparin removal in most patients.
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Dates et versions

hal-04548282 , version 1 (16-04-2024)

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Julien Aniort, Thierry Petitclerc, Caroline Créput. Safe Use of Citric Acid-Based Dialysate and Heparin Removal in Postdilution Online Hemodiafiltration. Blood Purification, 2012, 34 (3-4), pp.336-343. ⟨10.1159/000345342⟩. ⟨hal-04548282⟩
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