A 55-year-old man on ICU develops AKI requiring CRRT. He is receiving IV vancomycin. The team uses citrate-based regional anticoagulation (RCA) for th...

Question

A 55-year-old man on ICU develops AKI requiring CRRT. He is receiving IV vancomycin. The team uses citrate-based regional anticoagulation (RCA) for the CRRT circuit instead of heparin. What is the advantage of citrate RCA over heparin anticoagulation for CRRT?

Accepted Answer

Citrate chelates ionised calcium in the circuit blood, preventing coagulation LOCALLY without systemic anticoagulation - this reduces the bleeding risk compared to systemic heparin while maintaining circuit patency; calcium is then replaced systemically post-filter

Answer

Citrate is cheaper than heparin

Answer

Citrate is always superior in HIT

Answer

Citrate has no effect on coagulation

Answer

Heparin is always preferred over citrate

uk-fficm MCQ (SBA): Citrate Anticoagulation for CRRT

A 55-year-old man on ICU develops AKI requiring CRRT. He is receiving IV vancomycin. The team uses citrate-based regional anticoagulation (RCA) for the CRRT circuit instead of heparin. What is the advantage of citrate RCA over heparin anticoagulation for CRRT?