Abstract:

Objective： To analyze the effect of low calcium and standard calcium dialysate segmented citrate anticoagulant hemodialysis in the treatment of uremia patients with high risk of bleeding. Methods：High-risk bleeding patients undergoing hemodialysis at the First Affiliated Hospital of Dali University from January 2021 to January 2022 were enrolled in the study. Low calcium dialysate（control group） and standard calcium dialysate （observation group） were used for segmented citrate anticoagulation. The general data before treatment， the concentration of free calcium ions at the arterial and venous ends at 0.5， 2.0， and 3.0 hours after treatment， the amount of citrate infused at the arterial and venous pot， the coagulation status of the dialyzer and pipeline， and the incidence of adverse events were compared between the two groups. Results： The concentration of free calcium ions in the arterial end and venous end of the observation group was significantly higher than that of the control group at the same time period. The infusion speed of citrate in the arterial end and venous pot was faster， and the duration of dialysis was shorter. The differences had statistical significance（P＜0.05）. The total coagulation rate of the dialysis pipeline （especially the venous pot ） in the observation group was higher than that in the control group， but the incidence of adverse events was significantly lower in the observation group than in the control group， with statistical significance（P＜0.05）. Conclusion： The use of standard calcium dialysate with segmented citrate anticoagulation is safe and associated with fewer adverse events. The venous pot is the main coagulation site， and increasing the amount of citrate infusion and monitoring the calcium level after filtration frequently can ensure smooth completion of hemodialysis in patients with high-risk bleeding.

Key words:

"> font-size:10.5pt, ">low calcium dialysate, standard calcium dialysate, segmented citrate anticoagulation, hemodialysis, high-risk bleeding