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Citrate is the recommended anticoagulant for continuous renal replacement therapy (RRT) [1], and is thought to confer numerous benefits, including more continuous hours of filtration, fewer total circuits used, less overall cost and maybe improved patient and kidney survival when compared with heparin anticoagulation [2]. Our ICU changed from heparin to citrate anticoagulation in June 2014. Our unit uses a transfusion trigger of 7g/dl [3] unless the clinical situation dictates otherwise.

Blood transfusion requirements and filter longevity with regional citrate anticoagulation compared with heparin