{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:58:36Z","timestamp":1785257916570,"version":"3.55.0"},"reference-count":18,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Blood Purif"],"abstract":"<jats:p>Introduction: This single-center randomized controlled trial (NCT 03562754) compared pre-diluted IHDF (PIHDF) without systemic anticoagulation and the Prometheus system with regional citrate anticoagulation (RCA) in high-bleeding-risk patients. Methods: Intermittent hemodialysis (IHD) with RCA (IHD-RCA) with the Prometheus\u00ae device and PIHDF with a 5008H\u00ae dialysis monitor using priming and pre-dilution HDF online (25 mL\/min) were compared in a 4-h IHD session for 60 high-bleeding-risk patients between 2019 and 2020. Bleeding risk was defined by a nephrologist. Successful hemodialysis was defined as no premature interruption of the 4-h session. We also analyzed adequacy (KT\/V), dialyzer membrane status, cost, and organization from the nurse\u2019s viewpoint. Results: Eighty-two percent of patients were on chronic IHD and 41% had a fistula. Three patients in the IHD-RCA arm were excluded for early vascular access failure or persistent oral anticoagulation. No statistically significant difference was observed for the primary outcome between the two techniques (96% vs. 83%, p = 0.11). With PIHDF, 2 in 5 sessions failed after 3 h. No statistically significant difference in KT\/V was observed between groups (1.69 vs. 1.61, p = 0.27), but a significantly higher mean blood flow for PIHDF was reached (294 vs. 263 mL\/min, p &lt; 0.001). The visual coagulation score was significantly worse for PIHDF (p &lt; 0.01). No difference in clinical tolerance was found between groups. Hospital costs were higher with IHD-RCA than with PIHD, mainly due to the nurse\u2019s workload. Conclusion: Statistically, the primary outcome was not significantly different between techniques. The Prometheus device is efficient and clinically well tolerated, but PIHD is a cheaper, simpler procedure with little risk of coagulation if the session only lasts 3 h.<\/jats:p>","DOI":"10.1159\/000552412","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:03:50Z","timestamp":1780934630000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Intermittent Hemodialysis with Regional Citrate Anticoagulation versus Priming Heparin and Pre-Dilution HDF in Patients at Risk of Bleeding in Nephrology (The ROBIN Randomized Control Trial)"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-1415","authenticated-orcid":false,"given":"Olivier","family":"Moranne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Gerbal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihame","family":"Chkair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain","family":"Cariou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Prouvot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Reboul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Pambrun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Chevallier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihad","family":"Messikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2010.01298.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.18618"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2012.01101.x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-015-0102-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.30551"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.11.030"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12774"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S165925"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.225"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv347"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/sdi.12380"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2007.02.001"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2007.00459.x"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/1744-9987.12429"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-4758.2012.00733.x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002694"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.05.013"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2011.09.007"}],"container-title":["Blood Purification"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000552412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:00:46Z","timestamp":1785254446000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000552412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":18,"URL":"https:\/\/doi.org\/10.1159\/000552412","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.32576556","asserted-by":"subject"}]},"ISSN":["0253-5068","1421-9735"],"issn-type":[{"value":"0253-5068","type":"print"},{"value":"1421-9735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]}}}