Kidney Disease
Conditions
Interventions
Control Group:Single-Phase Citrate Anticoagulation
Intervention Group:Two-Segment Citrate Anticoagulation
Sponsors
Peking University First Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1. Age: Patients aged =18 years. 2. Indication: With an indication for IHD (Intermittent Hemodialysis). 3. Vascular Access: Well-functioning vascular access required. If using a central venous catheter (CVC) for dialysis: must be connected in the normal direction. Palindrome™ catheter (due to its symmetric design): May be connected in normal or reversed direction (minimal recirculation). 4. High Bleeding Risk (meeting =1 of the following): a. Active bleeding (e.g., hemoptysis, gastrointestinal bleeding, cerebral hemorrhage). b. Coagulopathy: PT or APTT above the upper limit of normal (ULN); OR Platelet count below the lower limit of normal (LLN). c. Peri-procedural period: Within 1 day before surgery/invasive procedure; AND within 7 days after surgery/invasive procedure.
Exclusion criteria
Exclusion criteria: 1. Severe Hepatic Impairment (Total bilirubin (TBIL) =60 µmol/L); 2. Refractory Shock Persistent hypotension (SBP 3 mmol/L 5. Severe Hypocalcemia, Serum total calcium <1.8 mmol/L 6. Concurrent Clinical Trial Participation 7. Currently enrolled in another interventional clinical study Contraindication to High-Flux Dialyzer Not suitable for polyarylethersulfone (PAES) high-flux membrane dialyzers 8. Contraindication to Low-Potassium Dialysate Pre-dialysis hypokalemia (serum K? <3.5 mmol/L) 9. Exclusion applies to protocols using low-potassium dialysate Recent Anticoagulant/Thrombolytic Use: Within 24 hours: Heparin, LMWH, argatroban, nafamostat mesilate, gabexate mesilate, bivalirudin, urokinase, alteplase Within 5 days: Warfarin, danaparoid, fondaparinux, rivaroxaban, dabigatran etexilate, apixaban, edoxaban
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Early circuit termination or filter replacement due to extracorporeal circuit clotting; | — |
Secondary
| Measure | Time frame |
|---|---|
| Premature Circuit Termination or Filter Replacement Due to Any Cause;First Filter Lifespan;Initial Filter Clotting Severity Score;Clot Burden in Venous Chamber at Discontinuation of the First Circuit;Severe Complications Associated with Citrate Anticoagulation;Whether to adjust the citrate infusion rate based on blood gas analysis results;Whether to administer intravenous calcium gluconate based on blood gas analysis results; | — |
Countries
China
Contacts
Public ContactXu Damin
Peking University First Hospital
Outcome results
None listed