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Kidney Week

Abstract: TH-PO1201

Controlled, Randomized Clinical Trial of Personalized Two-Phase Regional Citrate Anticoagulation in Prolonged Intermittent Kidney Replacement Therapy

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Zhang, Qi, Shanghai Jiao Tong University, Shanghai, China
  • Bi, Xiao, Shanghai Jiao Tong University, Shanghai, China
  • Ma, Jun, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
  • Xue, Jun, Huashan Hospital Fudan University, Shanghai, China
  • Zheng, Yin, Huashan Hospital Fudan University, Shanghai, China
  • Yu, Chen, Tongji Hospital Affiliated to Tongji University, Shanghai, China
  • Zhu, Zhuxian, Tongji Hospital Affiliated to Tongji University, Shanghai, China
  • Lu, Jianxin, Shanghai Jiao Tong University, Shanghai, China
  • Gu, Leyi, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
  • Zhang, Weiming, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
  • Zhu, Mingli, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China
  • He, Yining, Shanghai Jiao Tong University, Shanghai, China
  • Chen, Xiaonong, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
  • Ding, Feng, Shanghai Jiao Tong University, Shanghai, China
Background

A pharmacokinetics-driven personalized protocol was established for head-to-head efficacy and safety evaluation with conventional RCA .

Methods

A total of 144 patients from 5 hospitals were randomized in a 1:1 ratio to receive either personalized RCA or conventional RCA using Fresenius Ci-Ca protocol. The primary outcome was the non-intervention rate.

Results

The personalized two-phase RCA group achieved a higher non-intervention rate (96.9% vs 87.1%; p<0.01) and target attainment rate (78.4% vs 61.1%; p<0.01) with reduced hypocalcemia incidence (14.1% vs 50.7%; p<0.01, Table 1). Notably, 77.5% of intervention patients required no citrate or calcium adjustments versus 23.9% in control, with personalized RCA minimizing ionized calcium fluctuations(Fig. 1). Filter lifespan, acid-base status and serum sodium levels showed no significant differences.

Conclusion

Pharmacokinetic-driven personalized RCA significantly enhances iCa stability and decreases interventions that demonstrates superior safety and efficacy over conventional RCA in critically ill patients.

Figure 1. Changes in iCa, citrate and calcium supplement dose in PIKRT.

Funding

  • Commercial Support – Shanghai SuperbMed Medical Technology Co., Ltd

Digital Object Identifier (DOI)