Table 1.
Clinical features of patients receiving RCA and heparin-free protocol for IRRT
| Variables | Total (n = 141) | RCA (n = 48) | heparin-free (n = 93) | P value |
|---|---|---|---|---|
| Age(year), M(IQR) | 54 ± 19 | 54 ± 20 | 51 ± 19 | 0.375 |
| Male gender, n (%) | 76(54) | 33(69) | 43(46) | 0.011 |
| BMI(kg/m2) | 26(18,32) | 24(23,26) | 25 ± 6 | 0.587 |
| AKI | 68(48) | 26(54) | 42(45) | 0.311 |
| CKD | 73(52) | 22(46) | 51(55) | |
| Baseline diseases Hypertension, n (%) | 116(82) | 39(81) | 77(83) | 0.820 |
| Diabetes mellitus, n (%) | 15(11) | 5(10) | 10(11) | 0.934 |
| Liver disease, n (%) | 12(9) | 5(10) | 7(8) | 0.542 |
| Coronary heart Disease, n (%) | 17(12) | 6(13) | 11(12) | 0.908 |
| Medications Warfarin, n (%) | 17(12) | 5(10) | 12(13) | 0.667 |
| Anti-platelet drugs, n (%) | 21(15) | 4(8) | 17(18) | 0.116 |
| Mean arterial pressure at dialysis start (mmHg) | 99.9 ± 13.9 | 102.7 ± 14.7 | 98.4 ± 13.4 | 0.099 |
| Laboratory data Hemoglobin (g/L) | 90.7 ± 19.0 | 89.7 ± 16.7 | 91.3 ± 20.1 | 0.646 |
| Platelet count, (x 109) | 140.0(91.0,209.5) | 142.0(96.3,219.3) | 142.2 ± 74.1 | 0.295 |
| Serum albumin (g/L) | 32.0 ± 6.5 | 31.6 ± 5.4 | 32.1 ± 7.0 | 0.658 |
| Serum creatinine(µmol/L) | 554.0 ± 234.5 | 518.3(379.5,702.2) | 542.3 ± 228.1 | 0.702 |
| Magnesium(mmol/L) | 0.9(0.8,1.0) | 0.9(0.8,1.0) | 0.9 ± 0.2 | 0.219 |
| Phosphate(mmol/L) | 1.3(1.1,1.7) | 1.3(1.1,1.7) | 1.3(1.1,1.6) | 0.787 |
| Alanine aminotransferase(IU/L) | 12.0(7.0,17.0) | 12.0(6.8,18.0) | 11.5(7.8,17.0) | 0.958 |
| Aspartate aminotransferase(IU/L) | 16.0(13.0,22.0) | 16.0(12.8,21.0) | 17.0(14.0,22.0) | 0.331 |
| γ-Glutamyl transferase(IU/L) | 25.0(17.0,54.0) | 30.5(20.8,54.5) | 23.5(15.0,52.5) | 0.075 |
| Alkaline phosphatase(IU/L) | 68.0(53.0,87.0) | 68.0(55.8,84.3) | 68.5(52.8,87.0) | 0.986 |
| Total bilirubin(µmol/L) | 10.4(7.5,13.1) | 11.2(8.6,13.3) | 10.0(7.3,12.9) | 0.328 |
| Coagulation factors | ||||
| APTT (s) | 30.4(28.4,32.3) | 29.7(28.4,31.5) | 30.5(28.3,32.6) | 0.330 |
| PT (s) | 11.2(10.4,11.8) | 11.4(10.8,12.0) | 10.9(10.3,13.1) | 0.075 |
| INR | 1.0(0.9,1.0) | 1.0(0.9,1.0) | 1.0(0.9,1.0) | 0.103 |
| Fibrinogen (g/L) | 3.4 ± 1.2 | 3.5(2.6,4.4) | 3.2(2.5,3.9) | 0.126 |
| R (min) | 6.1(4.7,6.8) | 5.7(4.8,6.6) | 6.1(4.7,7.0) | 0.391 |
| K (min) | 1.4(1.2,1.8) | 1.4(1.1,1.7) | 1.4(1.2,2.0) | 0.286 |
| α-angle(deg) | 70.2(64.7,73.9) | 70.4(65.6,74.4) | 70.0(63.4,73.3) | 0.362 |
| MA (mm) | 61.6 ± 9.7 | 62.3(55.7,70.0) | 60.4(55.0,68.0) | 0.296 |
| Ly30(%) | 0.1(0.1,0.15) | 0.1(0.1,0.3) | 0.1(0.1,0.1) | 0.157 |
| Influencing factors to clotting-related premature termination | ||||
| Vascular access | 0.245 | |||
| Arteriovenous fistula | 24(17) | 5(10) | 19(20) | |
| Temporary central femoral catheter | 17(12) | 6(13) | 11(12) | |
| Temporary central jugular catheter | 53(38) | 17(35) | 36(39) | |
| Tunneled central venous access | 47(33) | 20(42) | 27(29) | |
| Dialyzers | < 0.001 | |||
| FX600 | 38 (27) | 2 (4) | 36 (39) | |
| FX60 | 56 (40) | 10 (21) | 46 (49) | |
| FX8 | 4 (3) | 1 (2) | 3 (3) | |
| 150G | 36 (26) | 30 (63) | 6 (6) | |
| 15G | 7 (5) | 5 (10) | 2 (2) | |
| Delivered blood flow rate (ml/min) | 220 (200,230) | 200 (180,200) | 220 (200,250) | < 0.001 |
| Citrate infusion rate | NA | 216.0 ± 20.6 | NA | |
| Dialysate with calcium concentration of 1.5mmol/L | 131(92.9) | 44(93.6) | 87(94.6) | 0.795 |
| Net ultrafiltration | 1.6 ± 1.0 | 1.9 ± 1.0 | 1.4 ± 0.9 | 0.010 |
| Kt/V* | 0.7 ± 0.4 | 0.7 ± 0.4 | 0.7 ± 0.4 | 0.993 |
| URR* | 0.4 ± 0.2 | 0.4 ± 0.2 | 0.4 ± 0.2 | 0.872 |
| Adverse events, n (%) | ||||
| Metabolic acidosis | 9 (6) | 3 (6) | 6 (6) | 1.000 |
| Severe alkalosis | 2 (1) | 1 (2) | 1 (1) | 1.000 |
| Hypocalcemia | 7 (5) | 1 (2) | 6 (6) | 0.423 |
Data are n (%) or median (IQR)
NA, not available
Anti-platelet drugs included aspirin, clopidogrel, and ticagrelor. AKI: Acute kidney injury; CKD: Chronic kidney disease; eGFR: Estimated glomerular filtration rate; Alb: Albumin; APTT: Plasma activated partial prothrombin time; PT: Prothrombin time; INR: International normalized radio; R: Reaction time; K: K-time; MA: Maximal amplitude; Kt/V: urea clearance index; URR: urea reduction ratio. P < 0.05 vs. CKD group. * 34 patients had data of blood urea nitrogen available for Kt/V and URR calculation (9 in RCA group and 25 in heparin-free group)