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VOLUME 24 , ISSUE S3 ( April, 2020 ) > List of Articles


Anticoagulation during Renal Replacement Therapy

Simran Singh

Keywords : Continuous renal replacement therapy, Low-molecular-weight heparin, Unfractionated heparin

Citation Information : Singh S. Anticoagulation during Renal Replacement Therapy. Indian J Crit Care Med 2020; 24 (S3):112-116.

DOI: 10.5005/jp-journals-10071-23412

License: CC BY-NC 4.0

Published Online: 25-08-2015

Copyright Statement:  Copyright © 2020; The Author(s).


  1. Venkataraman R, Kellum JA, Pavelsky P. Dosing pattern for continuous renal replacement at a large academic centre in United states. J Crit Care 2002;17(4):246–250. DOI: 10.1053/jcrc.2002.36757.
  2. Joannidis M, Oudemans-van Straaten HM. Clinical review: Patency of the circuit in continuous renal replacement therapy. Crit Care 2007;11(4):218. DOI: 10.1186/cc5937.
  3. Bellomo R, Ronco C. Anticoagulation during CRRT. In: Bellomo R, Baldwin I, Ronco C, Golper T. Atlas of haemofiltration. Sydney: W.B. Saunders; 2002. pp. 63–68.
  4. Tolwani AJ, Wille KM. Anticoagulation for continuous renal replacement therapy. Semin Dial 2009;22(2):141e5. DOI: 10.1111/j.1525-139X.2008.00545.x.
  5. Butterworth J, Lin YA, Prielipp R, Bennett J, James R. The pharmacokinetics and cardiovascular effects of a single intravenous dose of protamine in normal volunteers. Anesth Analg 2002;94(3):514–522. DOI: 10.1097/00000539-200203000-00008.
  6. Carr JA, Silverman N. The heparin-protamine interaction. A review. The J Cardiovasc Surg 1999;40(5):659–666.
  7. Gattas DJ, Rajbhandari D, Bradford C, Buhr H, Lo S, Bellomo R. A randomized controlled trial of regional citrate versus regional heparin anticoagulation for continuous renal replacement therapy in critically ill adults. Crit Care Med 2015;43(8):1622–1629. DOI: 10.1097/CCM.0000000000001004.
  8. Davenport A. Anticoagulation for continuous renal replacement therapy. Contribut Nephrol 2004;144:228–238. DOI: 10.1159/000078891.
  9. Amiral J, Peynaud-Debayle E, Wolf M, Bridey F, Vissac AM, Meyer D. Generation of antibodies to heparin-PF4 complexes without thrombocytopenia in patients treated with unfractionated or low-molecular-weight heparin. Am J Hematol 1996;52(2):90–95. DOI: 10.1002/(SICI)1096-8652(199606)52:23.0.CO;2-0.
  10. Leithäuser B, Schumacher J, Lendemans S, Tillmanns H, Matthias FR. Antithrombin attenuates microvascular leakage and leukocyte-endothelial interaction in response to endotoxin. Semin Thromb Hemost 2002;28(Suppl. 1):87–94. DOI: 10.1055/s-2002-30201.
  11. Thota R, Ganti AK, Subbiah S. Apparent heparin resistance in a patient with infective endocarditis secondary to elevated factor VIII levels. J Thromb Thrombolysis 2012;34(1):132–134. DOI: 10.1007/s11239-012-0692-z.
  12. Kellum JA, Lameire N, Aspelin P. Kidney disease: Improving global outcomes (KDIGO) acute kidney injury work group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl 2012;2(1):1–138. DOI: 10.1038/kisup.2012.1.
  13. Hirsh J, Bauer KA, Donati MB, Gould M, Samama MM, Weitz JI. Parenteral anticoagulants: American College of Chest Physicians evidence-based clinical practice guidelines. 8th ed. Chest 2008;133(Suppl. 6):141S–159S. DOI: 10.1378/chest.08-0689.
  14. Murray PT, Reddy BV, Grossman EJ, Hammes MS, Trevino S, Ferrell J, et al. A prospective comparison of three argatroban treatment regimens during hemodialysis in end-stage renal disease. Kidney Int 2004;66(6):2446–2453. DOI: 10.1111/j.1523-1755.2004.66022.x.
  15. Oudemans-Van Straaten HM, Bosman RJ, Koopmans M, van der Voort PH, Wester JP, van der Spoel JI, et al. Citrate anticoagulation for continuous venovenous hemofiltration. Crit Care Med 2009;37(2):545–552. DOI: 10.1097/CCM.0b013e3181953c5e.
  16. Oudemans-Van Straaten HM. Anticoagulation for renal replacement therapy: Heparin or citrate. In: Kuhlen R, Moreno R, Rhodes RM. Controversies in Intensive Care Medicine 2008. pp. 153–161.
  17. Claure-Del Granado R, Macedo E, Soroko S, Kim Y, Chertow GM, Himmelfarb J, , et al. Anticoagulation, delivered dose and outcomes in CRRT: The program to improve care in acute renal disease (PICARD). Hemodial Int 2014;18(3):641–649. DOI: 10.1111/hdi.12157.
  18. Hofbauer R, Moser D, Frass M, Oberbauer R, Kaye AD, Wagner O, et al. Effect of anticoagulation on blood membrane interactions during hemodialysis. Kidney Int 1999;56(4):1578–1583. DOI: 10.1046/j.1523-1755.1999.00671.x.
  19. Bai M, Zhou M, He L, Ma F, Li Y, Yu Y, et al. Citrate versus heparin anticoagulation for continuous renal replacement therapy: an updated meta-analysis of RCTs. Intensive Care Med 2015;41(12):2098–2110. DOI: 10.1007/s00134-015-4099-0.
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