{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:39:14Z","timestamp":1792787954738,"version":"4.5.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"1\u00b73\u00b75 project for disciplines of excellence\u2013Clinical Research Incubation Project, West China Hospital, Sichuan University","award":["ZYGD23015"],"award-info":[{"award-number":["ZYGD23015"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Regional citrate anticoagulation (RCA) is recommended as the first choice of anticoagulation strategies in continuous renal replacement therapy (CRRT). However, when using calcium-containing replacement fluid, whether RCA can achieve sufficient anticoagulant effect among different CRRT modalities remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this open-label, three-arm, randomized trial, AKI patients receiving RCA-CRRT with calcium-containing replacement fluids were randomized to continuous veno-venous hemofiltration (CVVH), continuous veno-venous hemodialysis (CVVHD) and continuous veno-venous hemodiafiltration (CVVHDF) groups from 2022 to 2023. The primary outcomes were circuit lifespan and early circuit failure. Secondary endpoints included the safety of the three groups and 30-day all-cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 121 patients were enrolled, with 40 in CVVH group, 40 in CVVHD group, and 41 in CVVHDF group. The circuit lifespan in CVVHDF group (70\u00a0h, IQR 65\u201372) was significantly longer than that in CVVHD (47\u00a0h, IQR 31.5\u201354) and CVVH group (64\u00a0h, IQR 46\u201371) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Meanwhile, 27 circuits remained patent for 72\u00a0h (CVVH: 10\/40, 25%; CVVHD: 1\/40, 2.5%; CVVHDF: 16\/41, 39.02%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). A significantly lower incidence of severe venous chamber thrombosis was observed in the CVVHDF group (2.4%, 1\/41) relative to the CVVH (5%, 2\/40) and CVVHD (50%, 20\/40) groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Furthermore, early circuit failure (lifespan\u2009&lt;\u200948\u00a0h) was observed in 35 circuits, occurring significantly more frequently in the CVVHD group (52.5%, 21\/40) than in either the CVVH (22.5%, 9\/40) or CVVHDF (12.2%, 5\/41) groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggested that RCA-CRRT with calcium-containing replacement solution appeared to be safe and effective, with CVVHDF showing potentially prolonged filter survival compared to alternative modalities, which might support its consideration as a possible option in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      This study was registered in the Chinese Clinical Trial Registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.chictr.org.cn\" ext-link-type=\"uri\">www.chictr.org.cn<\/jats:ext-link>\n                      ) under the registration number ChiCTR2200061065 on 15 June 2022.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12882-025-04565-7","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T11:32:12Z","timestamp":1762428732000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and safety of regional citrate anticoagulation using calcium-containing replacement solution in different modalities of continuous renal replacement therapy: a randomized controlled trial"],"prefix":"10.1186","volume":"26","author":[{"given":"Peiyun","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingpeng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanhong","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhifeng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"issue":"9","key":"4565_CR1","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1038\/nrneph.2010.100","volume":"6","author":"JR Prowle","year":"2010","unstructured":"Prowle JR, Bellomo R. 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It received ethical approval from the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (Approval No. 2022\u2009\u2212\u2009554) and was registered with the Chinese Clinical Trial Registry (ChiCTR2200061065). Only patients who provided written informed consent were included.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors of this work have nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"624"}}