Comparison of efficacy and prognosis between citrate and low molecular weight heparin in tumor patients undergoing continuous renal replacement therapy

Abstract

Objective To compare the effect of citrate on anticoagulation efficacy and outcome with low molecular weight heparin during continuous renal replacement treatment (CRRT) in cancer patients. Methods Retrospectively analyze the clinical data of 117 patients admitted in intensive care unit (ICU) of Sun Yat-sen University Cancer Center and received CRRT from September 2012 to October 2016. Among all patients, 18 patients received citrate (TCG group), while other 99 patients received low molecular heparin treatment (THG group). Rank-sum test was used to compare prothrombin time (PT), active partial thromboplastin time (APTT), blood platelet (PLT) count before CRRT. In addition, the change of PT, APTT, PLT, hemoglobin concentration during the first three days after CRRT, the stay of ICU and hospital and the filter life were also analyzed. Results In three days after CRRT, APTT in THG group was significant longer than patients in TCG group and there was a significant difference of APTT change between two groups [9.11(3.90, 9.11) s vs -0.94(-3.40, 3.38) s, Z=-4.001, P<0.001]. The filter life in TCG group was significant longer than that in THG group [29.64(19.47, 38.94) h vs 17.00(9.50, 24.40) h, Z=3.468, P=0.001]. However, there was no significant difference of PT, PLT, hemoglobin concentration change in 3 days after CRRT between two groups. What′s more, there was no difference of incidence of bleeding, length of ICU and hospital stay, and mortality, either. Conclusion In cancer patients, citrate had a better anticoagulation efficacy than low molecular weight heparinduring CRRT. Key words: Continuous renal replacement treatment; Citrate; Low molecular weight heparin; Anticoagulation; Prognosis