Application of two citrate anticoagulation methods in hemodialysis treatment after parathyroidectomy

  Objective  To compare the effects of two citrate anticoagulant methods in patients with hemodialysis after parathyroidectomy.

  Methods  Clinical data of 58 patients with hemodialysis after parathyroidectomy was retrospectively analyzed, and they received 4% citrate anticoagulant therapy for 98 times. A total of 34 patients(50 times) pumped with 300 mL/h of 4% citrate before the filter were selected as control group, while the other 24 patients(48 times) were treated with "two-stage" citrate anticoagulant method, in which 250 mL/h of 4% citrate was pumped before the filter and 50 mL/h of 4% citrate was pumped into the intravenous pot. The levels of calcium ion (Ca²⁺), bicarbonate ion (HCO₃^-), sodium ion (Na⁺) and pH values were compared between the two groups before and after hemodialysis. The coagulation levels of the two groups of dialyzer and dialysis line were compared.

  Results  Before dialysis, there were no significant differences in Na⁺, Ca²⁺, HCO₃^- and pH value between two groups (P>0.05). After dialysis, HCO₃^-, Na⁺ and pH value in two groups were higher compared with treatment before (P < 0.05), but there was no significant difference in Ca²⁺ level between the two groups (P>0.05). After dialysis, the Na⁺ level in the observation group was higher than that in the control group(P < 0.05). There were no statistically significant differences in the HCO₃^-, Ca⁺ and pH value between the two groups (P>0.05). There were statistically significant differences in the coagulation conditions of dialyzer and dialysis pipeline between two groups (P < 0.05).

  Conclusion  Compared with the traditional anticoagulation method of citrate, the "two-stage method" of citrate anticoagulation method is safe and effective, which can significantly reduce the incidence of coagulation in venous pot, ensure dialysis time for 4 h, and improve the effect of hemodialysis therapy.