{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T13:42:08Z","timestamp":1777902128107,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Clinical Evaluation of Regional Citrate Anticoagulation with Sodium Citrate in Continuous Renal Replacement Therapy (CRRT) for Patients with Hepatic Insufficiency Project","award":["2024061"],"award-info":[{"award-number":["2024061"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>It is to evaluate the efficacy and safety of regional citrate anticoagulation (RCA) in patients with hepatic insufficiency who develop acute kidney injury (AKI) and require continuous renal replacement therapy (CRRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included intensive care unit (ICU) patients with hepatic insufficiency\u2013associated AKI who were treated with CRRT between May 2024 and May 2025. After excluding incomplete records and performing 1:1 propensity score matching, 66 patients were analyzed: 39 received RCA and 27 received systemic heparin or no anticoagulation (non-RCA). Clinical characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Child\u2013Pugh class, filter lifespan, coagulation indices, metabolic parameters, and adverse events were also collected. The primary endpoints were filter lifespan, bleeding, and citrate accumulation. The secondary endpoints included filter lifespan, bleeding, citrate accumulation, treatment-related metabolic, coagulation changes and 28-day mortality. Multivariate logistic regression and receiver operating characteristic analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline illness severity was higher in the RCA group (APACHE II 30.46\u2009\u00b1\u20097.1 vs. 16.07\u2009\u00b1\u20095.3,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u2009.0001; median Child\u2013Pugh score 8 vs. 7,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.002). RCA showed a nonsignificant trend toward longer median filter lifespan compared with non-RCA (40.0 vs. 36.0\u2005h,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.219), with the largest numerical difference in Child\u2013Pugh class C. Lactate clearance after CRRT was greater in the RCA group (\u0394lactate 2.96\u2009\u00b1\u20097.56 vs. 0.10\u2009\u00b1\u20092.40\u2005mmol\/L,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u2009.037), while bleeding rates and coagulation changes were comparable. Citrate accumulation occurred in 12.5% of cases, and Child\u2013Pugh class B was independently protective. Age and APACHE II scores independently predicted 28-day mortality. Although the unadjusted mortality was higher in the RCA group, the difference was not significant after adjustment. A combined model including age, APACHE II score, and change in activated partial thromboplastin time showed a good predictive performance (area under the curve = 0.778).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RCA is safe and feasible in patients with hepatic insufficiency undergoing CRRT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261433391","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:18:14Z","timestamp":1773926294000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Regional citrate anticoagulation prolongs filter lifespan and improves metabolic control in CRRT for liver dysfunction-associated AKI: A retrospective cohort study"],"prefix":"10.1177","volume":"109","author":[{"given":"Wenpeng","family":"Jin","sequence":"first","affiliation":[{"name":"Shenzhen Longhua District Central Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengyu","family":"Chen","sequence":"additional","affiliation":[{"name":"The Third Affiliated Hospital of Southern Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Shenzhen Longhua District Central Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunbo","family":"Du","sequence":"additional","affiliation":[{"name":"Shenzhen Longhua District Central Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3416-6789","authenticated-orcid":false,"given":"Zhengxiong","family":"Li","sequence":"additional","affiliation":[{"name":"Shenzhen Longhua District Central Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03040322"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-022-02316-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-024-03663-z"},{"key":"e_1_3_3_5_2","first-page":"66","article-title":"Inducible metabolic pathway for citrate metabolism in case of major liver dysfunction: fact or fiction?","volume":"23","author":"Honore PM","year":"2019","unstructured":"Honore PM, De Bels D, Redant S, et al. Inducible metabolic pathway for citrate metabolism in case of major liver dysfunction: fact or fiction? Crit Care 2019; 23: 66.","journal-title":"Crit Care"},{"key":"e_1_3_3_6_2","article-title":"Citrate pharmacokinetics in critically ill patients with acute kidney injury","volume":"8","author":"Zheng Y","year":"2013","unstructured":"Zheng Y, Xu Z, Zhu Q, et al. Citrate pharmacokinetics in critically ill patients with acute kidney injury. 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Relationship between coagulopathy score and survival in critically ill patients with liver cirrhosis and sepsis: a retrospective study. 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