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    • Unapparent systemic effects of regional anticoagulation with citrate in continuous renal replacement therapy a narrative review
    Authors: Willem, Boer; Walter, Verbrugghe; Eric, Hoste;  Advisor: -;  Co-Author: - (2023)

    After citrate administration, calcium citrate complexes are formed. Clearance in diffusive modes increases with the dialysate flow, in convective modes with filtration flow [12]. Complexes that are not removed through the hemofilter return to the patient. In convective modes up to 60% of the citrate given prefilter is cleared via the hemofilter into the effluent (sometimes more in diffusive modes), the rest returning to the patient for metabolization [12]. Decreasing blood flow limits the amount of delivered citrate to the extracorporeal circuit. Limiting blood flows in convective modes in combination with high filtration rates may lead to a high filtration fraction. Therefore, higher blood flows resulting in a higher delivered citrate dose may be necessary in convective modes, comp...