Anticoagulation minimizes clotting in the extracorporeal circuit during hemodialysis but becomes a problem in patients with a high risk of bleeding complications. Different methods can prevent coagulation of dialysis circuits. In this study, we compare the effects of the AN69ST membrane and citrate-enriched dialysate on clotting events during dialysis in patients with a high risk of bleeding.

This retrospective study included 259 adults undergoing chronic hemodialysis and with a contraindication for using systemic heparinization: they had undergone renal transplantation or had a transplantectomy. They were hemodialyzed with AN69ST and acetate dialysate or with citrate-enriched dialysate and a polysulfone membrane. The primary outcome was defined as the need to interrupt a dialysis session because of clotting events. The secondary outcomes were the number of session with an increase of venous pressure and the variation of urea-reduction ratio.

A total of 144 patients were included in the AN69ST group and 115 patients in the citrate group. No significant difference was noted between the groups regarding premature termination of a dialysis session. No bleeding was noted. Urea-reduction ratio and variation in venous pressure during the session were significantly better in citrate-enriched dialysate group (P<0.001).

An AN69ST membrane with acetate dialysate was as effective as citrate-enriched dialysate with a polysulfone high-flux membrane with regards to premature termination of a dialysis session. However, urea-reduction ratio was significantly better and there were fewer cases of increased venous pressure in the citrate group (P<0.001).

An AN69ST membrane with acetate dialysate was as effective as citrate-enriched dialysate with a polysulfone high-flux membrane with regards to premature termination of a dialysis session. However, urea-reduction ratio was significantly better and there were fewer cases of increased venous pressure in the citrate group (P<0.001).