Regional Citrate Anticoagulation Versus No Anticoagulation During Continuous Renal Replacement Therapy in Critically Ill Patients at High Risk of Bleeding: A Meta-analysis of Randomized Controlled Trials.

Regional citrate anticoagulation improves circuit patency during continuous renal replacement therapy in critically ill patients with a high risk of bleeding, although it increases the risk of certain metabolic complications but does not affect mortality.

While regional citrate anticoagulation was associated with fewer reported major bleeding events than no anticoagulation, the certainty of evidence for this outcome was low and the finding should be interpreted with caution.