Abstract：
BACKGROUND: Calcium-free (Ca-free) solutions are theoretically the most ideal for regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT). However, the majority of medical centers in China had to make a compromise of using commercially available calcium-containing (Ca-containing) solutions instead of Ca-free ones due to their scarcity. This study was designed to probe into the potential of Ca-containing solution as a secure and efficient substitution for Ca-free solutions.
METHODS: In this prospective, randomized single-center trial, 99 patients scheduled for CRRT were randomly assigned in a 1:1:1 ratio to one of three treatment groups: continuous veno-venous hemodialysis Ca-free dialysate (CVVHD Ca-free) group, continuous veno-venous hemodiafiltration calcium-free dialysate (CVVHDF Ca-free) group, and continuous veno-venous hemodiafiltration Ca-containing dialysate (CVVHDF Ca-containing) group at cardiac intensive care unit (CICU). The primary endpoint was the incidence of metabolic complications. The secondary endpoints included premature termination of treatment, thrombus of filter, and bubble trap after the process.
RESULTS: The incidence of citrate accumulation (18.2% vs. 12.1% vs. 21.2%) and metabolic alkalosis (12.1% vs. 0% vs. 9.1%) did not significantly differ among three groups (p > 0.05 for both). The incidence of premature termination was comparable among the groups (18.2% vs. 9.1% vs. 9.1%, p = 0.582). The thrombus level of the filter and bubble trap was similar in the three groups (p > 0.05 for all).
CONCLUSIONS: In RCA-CRRT for CICU population, RCA-CVVHDF with Ca-containing solutions and traditional RCA with Ca-free solutions had a comparable safety and feasibility.
BACKGROUND: ChiCTR2100048238 in the Chinese Clinical Trial Registry.
METHODS: In this prospective, randomized single-center trial, 99 patients scheduled for CRRT were randomly assigned in a 1:1:1 ratio to one of three treatment groups: continuous veno-venous hemodialysis Ca-free dialysate (CVVHD Ca-free) group, continuous veno-venous hemodiafiltration calcium-free dialysate (CVVHDF Ca-free) group, and continuous veno-venous hemodiafiltration Ca-containing dialysate (CVVHDF Ca-containing) group at cardiac intensive care unit (CICU). The primary endpoint was the incidence of metabolic complications. The secondary endpoints included premature termination of treatment, thrombus of filter, and bubble trap after the process.
RESULTS: The incidence of citrate accumulation (18.2% vs. 12.1% vs. 21.2%) and metabolic alkalosis (12.1% vs. 0% vs. 9.1%) did not significantly differ among three groups (p > 0.05 for both). The incidence of premature termination was comparable among the groups (18.2% vs. 9.1% vs. 9.1%, p = 0.582). The thrombus level of the filter and bubble trap was similar in the three groups (p > 0.05 for all).
CONCLUSIONS: In RCA-CRRT for CICU population, RCA-CVVHDF with Ca-containing solutions and traditional RCA with Ca-free solutions had a comparable safety and feasibility.
BACKGROUND: ChiCTR2100048238 in the Chinese Clinical Trial Registry.
摘要：
背景：无钙（无Ca）溶液在理论上是连续肾脏替代疗法（CRRT）中最理想的局部柠檬酸抗凝（RCA）。然而,由于稀缺,中国大多数医疗中心不得不妥协使用市售含钙(含钙)溶液,而不是无钙溶液.这项研究旨在探讨含钙溶液作为无钙溶液的安全有效替代品的潜力。
方法：在此前瞻性中，随机单中心试验，将99名计划接受CRRT的患者以1：1：1的比例随机分配到三个治疗组之一：连续静脉-静脉血液透析无钙透析液（CVVHD无钙）组，连续静脉-静脉血液透析滤过无钙透析液（CVVHDF无钙）组，心脏重症监护病房（CICU）的连续静脉-静脉血液透析滤过含钙透析液（CVVHDF含钙透析液）组。主要终点是代谢并发症的发生率。次要终点包括提前终止治疗，过滤器血栓，和过程后的气泡陷阱。
结果：柠檬酸盐积累的发生率（18.2%vs.12.1%vs.21.2%）和代谢性碱中毒（12.1%vs.0%vs.9.1%)三组间无显著差异(两者p>0.05)。提前终止的发生率在各组之间具有可比性（18.2%vs.9.1%与9.1%，p=0.582)。过滤器和气泡捕集器的血栓水平在三组中相似(均p>0.05)。
结论：在针对CICU人群的RCA-CRRT中，含Ca溶液的RCA-CVVHDF和无Ca溶液的传统RCA具有相当的安全性和可行性。
背景：ChiCTR2100048238在中国临床试验注册。
方法：在此前瞻性中，随机单中心试验，将99名计划接受CRRT的患者以1：1：1的比例随机分配到三个治疗组之一：连续静脉-静脉血液透析无钙透析液（CVVHD无钙）组，连续静脉-静脉血液透析滤过无钙透析液（CVVHDF无钙）组，心脏重症监护病房（CICU）的连续静脉-静脉血液透析滤过含钙透析液（CVVHDF含钙透析液）组。主要终点是代谢并发症的发生率。次要终点包括提前终止治疗，过滤器血栓，和过程后的气泡陷阱。
结果：柠檬酸盐积累的发生率（18.2%vs.12.1%vs.21.2%）和代谢性碱中毒（12.1%vs.0%vs.9.1%)三组间无显著差异(两者p>0.05)。提前终止的发生率在各组之间具有可比性（18.2%vs.9.1%与9.1%，p=0.582)。过滤器和气泡捕集器的血栓水平在三组中相似(均p>0.05)。
结论：在针对CICU人群的RCA-CRRT中，含Ca溶液的RCA-CVVHDF和无Ca溶液的传统RCA具有相当的安全性和可行性。
背景：ChiCTR2100048238在中国临床试验注册。
