{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:31:17Z","timestamp":1780486277658,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100012245","name":"Science and Technology Planning Project of Guangdong Province","doi-asserted-by":"publisher","award":["2023A04J2182"],"award-info":[{"award-number":["2023A04J2182"]}],"id":[{"id":"10.13039\/501100012245","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ther Apher Dial"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Regional citrate anticoagulation (RCA) is highly recommended as an anticoagulation method for intermittent hemodialysis (IHD) in patients at high bleeding risk. Few studies have investigated the effect of ionized calcium (iCa) concentration at different pipeline points on circuit clotting in RCA using calcium\u2010containing dialysate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective study included 185 IHD sessions treated with a two\u2010stage RCA protocol. Ionized calcium levels were measured at different pipeline points. The primary endpoint was severe clotting in the extracorporeal circulation circuit (ECC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sessions with severe circuit clotting showed higher platelet counts, shorter activated partial thromboplastin time, greater dialyzer surface areas, and higher iCa concentrations around venous bubble trap (VBT). Cox regression models revealed that iCa concentration before VBT (per 0.10\u2009mmol\/L, hazard ratio (HR)\u2009=\u20091.54, <jats:italic>p<\/jats:italic>\u2009=\u20090.006) and baseline platelet count (HR\u2009=\u20091.01, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) were strongly associated with severe circuit clotting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The iCa concentration before VBT could serve as a key indicator of anticoagulant efficacy in RCA with calcium\u2010containing dialysate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1744-9987.70055","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T09:55:55Z","timestamp":1751190955000},"page":"730-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Ionized Calcium Before Venous Bubble Trap Strongly Affects Coagulation When Using Calcium\u2010Containing Dialysate in Regional Citrate Anticoagulation for Intermittent Hemodialysis: A Real\u2010World Prospective Study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2940-8782","authenticated-orcid":false,"given":"Zhen","family":"Ai","sequence":"first","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital, Sun Yat\u2010Sen University  Guangzhou China"},{"name":"NHC Key Laboratory of Clinical Nephrology (Sun Yat\u2010Sen University) and Guangdong Provincial Key Laboratory of Nephrology  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Nephrology Huidong People's Hospital  Huizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology Huadu District People's Hospital of Guangzhou  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haishan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital, Sun Yat\u2010Sen University  Guangzhou China"},{"name":"NHC Key Laboratory of Clinical Nephrology (Sun Yat\u2010Sen University) and Guangdong Provincial Key Laboratory of Nephrology  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital, Sun Yat\u2010Sen University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raoping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital, Sun Yat\u2010Sen University  Guangzhou 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