{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:50:01Z","timestamp":1792785001333,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Hunan Province Science and Technology Innovation Plan Project","award":["2020SK50509"],"award-info":[{"award-number":["2020SK50509"]}]},{"name":"the Hunan Province Science and Technology Innovation Plan Project","award":["2021SK50518"],"award-info":[{"award-number":["2021SK50518"]}]},{"name":"the Hunan Province Science and Technology Innovation Plan Project","award":["2021SK50506"],"award-info":[{"award-number":["2021SK50506"]}]},{"name":"the Health Commission of Hunan Province Scientific Research Plan Project","award":["C202306018490"],"award-info":[{"award-number":["C202306018490"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>There remains no optimal anticoagulation protocol for continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) in pediatric patients with elevated D-dimer levels. We aimed to assess the effects of different anticoagulation strategies on the risk of CRRT filter clotting in these patients. Pediatric patients undergoing CRRT were retrospectively grouped based on pre-CRRT D-dimer levels and anticoagulant: D-RCA group (normal D-dimer, RCA only, n\u2009=\u200922), D+\u2009RCA group (elevated D-dimer, RCA only, n\u2009=\u200950), and D+\u2009RCA+\u2009systemic heparin anticoagulation (SHA) group (elevated D-dimer, RCA combined with SHA, n\u2009=\u200955). The risk of filter clotting and incidence of bleeding were compared among the groups. Among the groups, the D+\u2009RCA+\u2009SHA group had the longest filter lifespan; further, the incidence of bleeding was not increased by concurrent use of low-dose heparin for anticoagulation. Moreover, concurrent heparin anticoagulation was associated with a decreased risk of filter clotting. Contrastingly, high pre-CRRT hemoglobin and D-dimer levels and post-filter ionized calcium level\u2009&gt;\u20090.4\u00a0mmol\/L were associated with an increased risk of filter clotting. RCA combined with low-dose heparin anticoagulation could reduce the risk of filter clotting and prolong filter lifespan without increasing the risk of bleeding in patients with elevated D-dimer levels undergoing CRRT.<\/jats:p>","DOI":"10.1038\/s41598-024-64433-6","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T06:02:47Z","timestamp":1718172167000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Citrate and low-dose heparin combined anticoagulation in pediatric continuous renal replacement therapy"],"prefix":"10.1038","volume":"14","author":[{"given":"Desheng","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenghui","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7167-0031","authenticated-orcid":false,"given":"Xinping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"64433_CR1","first-page":"CD12467","volume":"12","author":"H Tsujimoto","year":"2020","unstructured":"Tsujimoto, H. et al. 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