Regional citrate versus heparin anticoagulation for continuous renal replacement therapy in critically ill patients: A meta‐analysis of randomized controlled trials
Rui Li, Xiang Gao, Tao Zhou, Yunjie Li, Jianhui Wang, Peirong Zhang
Abstract
INTRODUCTION: This study aimed to compare the efficacy and safety of citrate and heparin in continuous renal replacement therapy (CRRT) for critically ill patients. METHODS: Searched in PubMed, Embase, and Cochrane Library databases. RESULTS: Analyses showed that there no difference existed in mortality, metabolic alkalosis, circuit loss, and the number of transfused between the two groups (RR = 0.95, p = 0.40; RR = 1.73, p = 0.40; RR = 0.64, p = 0.09; RR = 1.05, p = 0.70). The filter life of the citrate group was longer than the heparin group (MD = 16.98, p < 0.0001). The risk of bleeding and heparin-induced thrombocytopenia was significantly lower in the citrate (RR = 0.32, p < 0.00001; RR = 0.55, p = 0.04). The citrate group was more susceptible to hypocalcemia (RR = 4.85, p = 0.0004). CONCLUSION: Citrate anticoagulant therapy should have priority for CRRT in most critically ill patients.