Recent advances in continuous renal replacement therapy: citrate anticoagulated continuous arteriovenous hemodialysis.

Trisodium citrate was used as a regional anticoagulant on 24 patients on continuous arteriovenous hemodialysis (CAVHD), obviating the need for systemic heparinization. Principles of CAVHD, potential complications, and nursing responsibilities are addressed. Clearances, blood flow rate, ultrafiltration and filter patency compare favorably with heparin CAVHD. Citrate anticoagulated CAVHD avoids heparin-associated complications in the critically ill uremic patient.