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International Journal of Nephrology
Volume 2016, Article ID 9185413, 8 pages
http://dx.doi.org/10.1155/2016/9185413
Clinical Study

Is Anticoagulation Discontinuation Achievable with Citrate Dialysate during HDF Sessions?

1AUB Santé, Saint-Malo Dialysis Unit, 1 rue de la Marne, 35400 Saint-Malo, France
2Rennes 1 University, CHU Rennes Department of Clinical Pharmacology, INSERM Pharmacoepidemiology Team CIC0203 BIOSIT, 35043 Rennes, France
3Hôpital de Saint-Malo, Medical Laboratory, 35400 Saint-Malo, France

Received 4 June 2016; Revised 29 August 2016; Accepted 15 September 2016

Academic Editor: Alessandro Amore

Copyright © 2016 Thibault Dolley-Hitze et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Citrate dialysate has been developed for few years to replace acetate and HCl concentrates. In Online Postdilution Hemodiafiltration (OL-POST-HDF), several issues are remaining concerning the possibility of stopping anticoagulation during sessions and the side effects of citrate solutions on calcium metabolism. This 1-year monocentric retrospective study included all patients exposed to citrate in OL-POST-HDF with nadroparin decrease for more than one month. Clotting events, serum calcium, PTH, hemoglobin, CRP, depuration parameters, and treatments administrated were recorded for analysis. 27 patients experienced nadroparin decrease and 5 did not receive nadroparin at the end of the study. Nadroparin decrease and withdrawal were both associated with more clotting events whereas the use of vitamin K antagonists was protective. No significant metabolic side effects were observed. Citrate dialysate does not allow anticoagulation discontinuation or decrease but has no significant side effects on mineral bone metabolism or erythropoiesis.