Different anticoagulation methods for continuous renal replacement therapy in patients with hyperlactataemia and a high risk of bleeding

The present study included a total of 53 patients who underwent no anticoagulation (NA)-CRRT, 32 patients who underwent nafamostat mesylate (NM)-CRRT and 47 patients who underwent regional citrate anticoagulation (RCA)-CRRT. The filter lifespan was significantly different among the three groups (NA = 25 h (IQR = 18.4, 34.5), NM = 41 h (IQR = 24.0, 54.3) and RCA = 36 h (IQR = 23.0, 53.5), <i>p</i> < 0.001). The 30-day mortality rate was significantly higher in the NA group (<i>p</i> = 0.037). Furthermore, the incidence of bleeding complications (43.4%, <i>p</i> = 0.003) and blood transfusions (28.3%, <i>p</i> = 0.047) were higher in the NA group.ConclusionThe utilization of either NM or RCA has the potential to extend the filter lifespan and may be associated with a reduced risk of bleeding. These findings suggest that NM and RCA may be safe and effective for CRRT patients with hyperlactataemia and a high risk of bleeding if careful monitoring and timely adjustment are employed.