Key result
Simplified citrate anticoagulation linked to ~30-point higher partial response rate vs traditional protocol in hemodialysis.
Why the study?
The impact of simplified citrate anticoagulation eliminating calcium supplementation on clinical efficacy and prognosis compared to traditional citrate anticoagulation had not been comprehensively elucidated.
Does simplified citrate anticoagulation improve clinical efficacy, inflammatory markers, and patient prognosis compared to traditional citrate anticoagulation in patients with end-stage renal disease undergoing hemodialysis?
Cohort (n=109)
No
Does simplified citrate anticoagulation improve clinical efficacy, inflammatory markers, and patient prognosis compared to traditional citrate anticoagulation in patients with end-stage renal disease undergoing hemodialysis?
Absolute Event Rate: 61.54% vs 31.58%
p-value: p=<0.05
The simplified citrate anticoagulation protocol offers a streamlined alternative that may improve treatment response and patient quality of life without compromising safety in hemodialysis.
May support simplified protocols for partial response in hemodialysis; hypothesis-generating and requires randomized confirmation before practice change.
Hemodialysis (HD) is a critical therapy for patients with end-stage renal disease, and the choice of anticoagulation protocol is crucial for its success. The impact of simplified citrate anticoagulation that notably eliminates the need for calcium supplementation on clinical efficacy and patient prognosis in comparison to traditional citrate anticoagulation has not been comprehensively elucidated. This study aimed to assess the impact of different anticoagulation protocols on HD patients. A prospective cohort study was conducted involving 109 HD patients, comprising a traditional citrate anticoagulation group (n = 57) and a simplified citrate anticoagulation group (n = 52). Various clinical and prognostic parameters including coagulation, inflammatory markers, cardiovascular parameters, treatment response, and patient-reported outcomes were assessed. Correlative analyses were performed to explore the associations between different anticoagulation protocols and clinical and prognostic parameters. The simplified citrate anticoagulation group showed significantly prolonged activated partial thromboplastin time, higher levels of fibrinogen, interleukin-6, and white blood cell count compared to the traditional citrate anticoagulation group. The simplified citrate anticoagulation group also had a higher left ventricular ejection fraction, a higher rate of partial response (61.54% vs 31.58%), and a lower rate of stable disease (32.69% vs 63.16%). Additionally, the quality of life score was higher in the simplified citrate anticoagulation group. Correlative analysis revealed significant associations between the anticoagulation protocols and various clinical and prognostic parameters in HD patients. The simplified citrate anticoagulation protocol for HD demonstrates advantages across various domains, including coagulation parameters, inflammatory markers, cardiovascular parameters, treatment response, and patient prognosis.
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Wang et al. (2026) conducted a cohort in End-stage renal disease requiring hemodialysis (n=109). Simplified citrate anticoagulation vs. Traditional citrate anticoagulation was evaluated on Partial treatment response rate (p=<0.05). Simplified citrate anticoagulation was associated with a higher rate of partial treatment response compared to traditional citrate anticoagulation (61.54% vs 31.58%) in hemodialysis patients.
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