Anticoagulation en épuration extrarénale

Inadequate anticoagulation during renal replacement therapy (RRT) is associated with recurrent filter clotting and the need for frequent circuit replacement, increasing cost and requirements for blood transfusion. The “down-time” induced by frequent circuit clotting may also result in less effective treatment. Heparin and systemic anticoagulants may be associated with a high-risk of hemorrhagic complications. Various alternative methods have been developed for the anticoagulation of the circuit; including heparin minimization and regional anticoagulation using citrate or heparin-protamin combination. This paper reviews our current anticoagulation strategies for continuous RRT, according to the bleeding risk of the patient.