Wcn24-719 Citrate-Containing Dialysate for High Clotting Risk Haemodialysis Patients – A Pilot, Randomised Crossover Trial

Titrating the optimal anticoagulation dose for haemodialysis patients is an important yet difficult task. Excessive anticoagulation leads to bleeding and systemic heparinization whilst insufficient anticoagulation leads to clotting. Citrate, often used in regional citrate anticoagulation in continuous renal replacement, chelates calcium which is a key player in the clotting cascade. Citrate-containing dialysate is marketed to improve solute clearance and potentially reduces clotting. It is unknown whether switching from acetate-containing dialysate to citrate-containing dialysate for patients with high clotting risks could negate the increment in anticoagulation.