Simplified versus traditional citrate anticoagulation in hemodialysis: Impact on clinical efficacy and patient prognosis, and correlative analysis

Hemodialysis (HD) is a critical therapy for patients with end-stage renal disease, and the choice of anticoagulation protocol is crucial for its success. The impact of simplified citrate anticoagulation that notably eliminates the need for calcium supplementation on clinical efficacy and patient prognosis in comparison to traditional citrate anticoagulation has not been comprehensively elucidated. This study aimed to assess the impact of different anticoagulation protocols on HD patients. A prospective cohort study was conducted involving 109 HD patients, comprising a traditional citrate anticoagulation group (n = 57) and a simplified citrate anticoagulation group (n = 52). Various clinical and prognostic parameters including coagulation, inflammatory markers, cardiovascular parameters, treatment response, and patient-reported outcomes were assessed. Correlative analyses were performed to explore the associations between different anticoagulation protocols and clinical and prognostic parameters. The simplified citrate anticoagulation group showed significantly prolonged activated partial thromboplastin time, higher levels of fibrinogen, interleukin-6, and white blood cell count compared to the traditional citrate anticoagulation group. The simplified citrate anticoagulation group also had a higher left ventricular ejection fraction, a higher rate of partial response (61.54% vs 31.58%), and a lower rate of stable disease (32.69% vs 63.16%). Additionally, the quality of life score was higher in the simplified citrate anticoagulation group. Correlative analysis revealed significant associations between the anticoagulation protocols and various clinical and prognostic parameters in HD patients. The simplified citrate anticoagulation protocol for HD demonstrates advantages across various domains, including coagulation parameters, inflammatory markers, cardiovascular parameters, treatment response, and patient prognosis.