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Comparing Efficacy and Safety Between 4% Sodium Citrate and Unfractionated Heparin as a Locking Solution in Central Venous Tunneled Hemodialysis Catheter
摘要
BACKGROUND: Malfunction of central venous tunneled hemodialysis (HD) catheters is common in HD patients. Heparin has been used as a conventional locking solution for several years. However, few unfavorable adverse effects have been observed in clinical practice. Sodium citrate can be used as an alternative locking solution. This study aimed to investigate the efficacy and safety of locking solutions using sodium citrate in patients undergoing HD. METHODS: This single-center, case-controlled observational trial was conducted in a hospital-facilitated outpatient HD center in southern Taiwan. We evaluated the patency of central venous tunneled dialysis catheters, hemorrhage, and infectious events over 3 months by comparing unfractionated heparin vs. 4% sodium citrate from July to September 2022. RESULTS: Totally, 39 HD patients were enrolled in the study; 19 patients received unfractionated heparin, and 20 patients received 4% sodium citrate as the locking solution. There were more diabetics in the citrate group compared to the unfractionated heparin group (60.0% vs. 21.1%, P = 0.022). There were no significant differences in central venous tunneled dialysis catheter clots (15.8% in the heparin group vs. 5% in the citrate group, P = 0.342) and infection events (5.3% in the heparin group vs. 10% in the citrate group, P = 1.000). No hemorrhagic events occurred in any of the groups during the study period. CONCLUSIONS: The efficacy and safety of 4% sodium citrate as a locking solution in central venous tunneled HD catheters were comparable to those of unfractionated heparin.