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Abstract
Introduction Anticoagulation minimizes clotting in the extracorporeal circuit during hemodialysis but becomes a problem in patients with a high risk of bleeding complications. Different methods can prevent coagulation of dialysis circuits. In this study, we compare the effects of the AN69ST membrane and citrate-enriched dialysate on clotting events during dialysis in patients with a high risk of bleeding. Patients and methods This retrospective study included 259 adults undergoing chronic hemodialysis and with a contraindication for using systemic heparinization: they had undergone renal transplantation or had a transplantectomy. They were hemodialyzed with AN69ST and acetate dialysate or with citrate-enriched dialysate and a polysulfone membrane. The primary outcome was defined as the need to interrupt a dialysis session because of clotting events. The secondary outcomes were the number of session with an increase of venous pressure and the variation of urea-reduction ratio. Results A total of 144 patients were included in the AN69ST group and 115 patients in the citrate group. No significant difference was noted between the groups regarding premature termination of a dialysis session. No bleeding was noted. Urea-reduction ratio and variation in venous pressure during the session were significantly better in citrate-enriched dialysate group (P Discussion An AN69ST membrane with acetate dialysate was as effective as citrate-enriched dialysate with a polysulfone high-flux membrane with regards to premature termination of a dialysis session. However, urea-reduction ratio was significantly better and there were fewer cases of increased venous pressure in the citrate group (P Conclusion An AN69ST membrane with acetate dialysate was as effective as citrate-enriched dialysate with a polysulfone high-flux membrane with regards to premature termination of a dialysis session. However, urea-reduction ratio was significantly better and there were fewer cases of increased venous pressure in the citrate group (P
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