Comparative Analysis of Fixed Versus Variable Rates of Regional Citrate Anticoagulation in Critically Ill Adult Patients on Continuous Kidney Replacement Therapy

Fixed and variable citrate rates showed similar effectiveness in CKRT. However, the fixed rate was associated with less hypocalcemia and calcium supplementation without a significant increase in bleeding or thrombosis. These findings contribute new comparative data to help guide citrate anticoagulation strategies and suggest that a fixed rate may help minimize electrolyte disturbances and simplify supplementation needs. Given that the study was potentially underpowered, further studies are needed to validate these findings and guide the development of optimal citrate rate guidelines.