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Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Regional Citrate Anticoagulation (RCA) has emerged as the preferred anticoagulation method for Continuous Renal Replacement Therapy (CRRT) due to its excellent local anticoagulant effect and low bleeding risk. Currently, the recommended post-filter calcium ion concentration ranges from 0.25 to 0.35 mmol/L or 0.20 to 0.45 mmol/L. However, there remain controversies and uncertainties regarding the optimal control range of post-filter ionized calcium concentration and its impact on filter lifespan.
This study aimed to compare the effects of different post-filter calcium ion concentration control ranges on filter lifespan, the incidence of metabolic complications, treatment efficacy, and prognosis.
A total of 286 CRRT treatment sessions in 149 patients undergoing RCA-CRRT were included from the Smart-CRRT electronic information system, with 77 sessions in the low target group, 120 in the medium target group, and 89 in the high target group.
There were significant differences in filter lifespan among the three groups. The filter lifespans of the low, medium, and high target groups were 25.00 (24.00, 47.00) hours, 24.00 (24.00, 39.50) hours, and 24.00 (23.00, 28.00) hours, respectively, with statistical significance (P = 0.038). The filter lifespan in the high target group was significantly shorter than that in the other two groups (P < 0.05).
Significant differences were observed in the incidence of metabolic complications among the three groups. The low target group had the highest incidences of hypocalcemia (40.0% vs. 16.7% vs. 6.7%), acidosis (13.0% vs. 4.2% vs. 3.4%), and citrate accumulation (26.0% vs. 4.2% vs. 1.1%) (P < 0.05), while the medium and high target groups showed better safety profiles.
After treatment, serum creatinine and blood urea nitrogen levels significantly decreased in all three groups (P < 0.05). There were no significant differences in creatinine clearance rate or urea clearance rate among the groups (P > 0.05). In terms of coagulation function, only the low target group showed a slight increase in activated partial thromboplastin time (APTT) (P < 0.05), while there were no significant changes in coagulation indicators before and after treatment in the other two groups. No significant differences were found in CBC indicators before and after treatment among the three groups.
There was no statistically significant difference in the length of ICU stay among the three groups (P = 0.209). However, the low target group had a significantly higher mortality rate (P < 0.001).
Filter lifespan was negatively correlated with post-filter calcium ion concentration (r = -0.151, P = 0.010). Multiple linear regression results indicated that an increase in post-filter calcium ion concentration shortened filter lifespan (correlation coefficient = -33.056, P = 0.022), whereas an increase in replacement fluid volume prolonged filter lifespan (correlation coefficient = 13.200, P = 0.016).
During RCA-CRRT, a post-filter ionized calcium concentration ranging from 0.25 to 0.45 mmol/L provides a good anticoagulant effect, while a range of 0.36 to 0.55 mmol/L results in fewer metabolism-related complications.
