Abstract
This study aimed to compare the efficacy and safety of citrate and heparin in continuous renal replacement therapy (CRRT) for critically ill patients. Searched in PubMed, Embase, and Cochrane Library databases. Analyses showed that there no difference existed in mortality, metabolic alkalosis, circuit loss, and the number of transfused between the two groups (RR=0.95, p=0.40; RR=1.73, p=0.40; RR=0.64, p=0.09; RR=1.05, p=0.70). The filter life of the citrate group was longer than the heparin group (MD=16.98, p < 0.0001). The risk of bleeding and heparin-induced thrombocytopenia was significantly lower in the citrate (RR=0.32, p < 0.00001; RR=0.55, p=0.04). The citrate group was more susceptible to hypocalcemia (RR=4.85, p=0.0004). Citrate anticoagulant therapy should have priority for CRRT in most critically ill patients.
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