Effectiveness of Segmented Regional Citrate Anticoagulation in Paediatric Hemodialysis.

This study retrospectively compared the effectiveness and safety of segmented regional citrate anticoagulation (S-RCA) and single-segment RCA (SS-RCA) in pediatric hemodialysis. Fifty-two patients were divided into S-RCA (n = 26) and SS-RCA (n = 26) groups. Treatment parameters, ionized calcium, pH, bicarbonate, coagulation in the dialyzer and venous air trap, blood urea nitrogen (BUN), creatinine (Cr), electrolytes, total calcium, coagulation function, and complications were assessed. No significant differences were found in blood flow, dialysate flow, or ultrafiltration between groups. While anticoagulation efficacy in the dialyzer was similar, venous air trap anticoagulation was significantly better with S-RCA (p = 0.030). Post-dialysis, BUN and Cr levels decreased more significantly in the S-RCA group (p < 0.001). Electrolytes, total calcium, and coagulation parameters remained stable, with no severe adverse events. It was concluded that S-RCA provides superior anticoagulation efficacy and dialysis adequacy compared to SS-RCA in pediatric hemodialysis, offering an alternative anticoagulation regimen for this population.