Cochrane · systematic review · CD012467
Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy
Tsujimoto, H, Tsujimoto, Y, Nakata, Y, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
12
No studies
9
Included studies
NR
No studies 9 · 42.9%Ungraded 0 · 0%Very low 4 · 19%Low 5 · 23.8%Moderate 3 · 14.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyCitrate versus unfractionated heparin for continuous renal replacement therapy
Population: CRRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major bleeding Citrate vs unfractionated heparin | RR 0.22 [0.08, 0.62] | 7 studies · 535 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Death at 28 days Citrate vs unfractionated heparin | RR 1.06 [0.86, 1.3] | 5 studies · 462 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Successful prevention of clotting Citrate vs unfractionated heparin | RR 1.44 [1.1, 1.87] | 3 studies · 88 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Treatment cessation due to adverse events Citrate vs unfractionated heparin | RR 0.47 [0.15, 1.49] | 3 studies · 412 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Recovery of kidney function Citrate vs unfractionated heparin | RR 1.04 [0.89, 1.21] | 2 studies · 214 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Thrombocytopenia Citrate vs unfractionated heparin | RR 0.39 [0.14, 1.03] | 3 studies · 412 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Cost to health care services Citrate vs unfractionated heparin | no estimate extracted | NR | No studies |
Unfractionated heparin versus low molecular weight heparin for continuous renal replacement therapy
Population: CRRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major bleeding Unfractionated heparin vs low molecular weight heparin | RR 0.58 [0.13, 2.58] | 5 studies · 153 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Death: unknown time frame Unfractionated heparin vs low molecular weight heparin | RR 0.78 [0.51, 1.18] | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Successful prevention of clotting Unfractionated heparin vs low molecular weight heparin | RR 0.95 [0.7, 1.31] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Treatment cessation due to adverse events Unfractionated heparin vs low molecular weight heparin | RR 0.29 [0.02, 3.53] | 2 studies · 77 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Recovery of kidney function Unfractionated heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
Thrombocytopenia Unfractionated heparin vs low molecular weight heparin | RR 0.57 [0.2, 1.63] | 2 studies · 124 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Cost to health care services Unfractionated heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
Unfractionated heparin versus no pharmacological anticoagulation for continuous renal replacement therapy
Population: CRRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major bleeding Unfractionated heparin vs no pharmacological anticoagulation | RR 0.5 [0.05, 4.67] | 1 study · 10 participants | Very low Downgraded: risk of bias, imprecision |
Death at 28 days Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Successful prevention of clotting Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Treatment cessation due of adverse events Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Recovery of kidney function Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Thrombocytopenia Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Cost to health care services Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Citrate versus unfractionated heparin for continuous renal replacement therapy
Population: CRRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major bleeding Citrate vs unfractionated heparin | RR 0.22 [0.08, 0.62] | 7 studies · 535 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Death at 28 days Citrate vs unfractionated heparin | RR 1.06 [0.86, 1.3] | 5 studies · 462 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Successful prevention of clotting Citrate vs unfractionated heparin | RR 1.01 [0.77, 1.32] | 3 studies · 88 participants | Moderate Downgraded: risk of bias, imprecision, indirectness |
Treatment cessation due to adverse events Citrate vs unfractionated heparin | RR 0.47 [0.15, 1.49] | 3 studies · 412 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Recovery of kidney function Citrate vs unfractionated heparin | RR 0.95 [0.66, 1.36] | 2 studies · 242 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Thrombocytopenia Citrate vs unfractionated heparin | RR 0.39 [0.14, 1.03] | 3 studies · 412 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Cost to health care services Citrate vs unfractionated heparin | no estimate extracted | NR | No studies |
Unfractionated heparin versus low molecular weight heparin for continuous renal replacement therapy
Population: CRRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major bleeding Unfractionated heparin vs low molecular weight heparin | RR 0.58 [0.13, 2.58] | 5 studies · 153 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Death: unknown time frame Unfractionated heparin vs low molecular weight heparin | RR 0.78 [0.51, 1.18] | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Successful prevention of clotting Unfractionated heparin vs low molecular weight heparin | RR 1.28 [0.94, 1.76] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Treatment cessation due to adverse events Unfractionated heparin vs low molecular weight heparin | RR 0.29 [0.02, 3.53] | 2 studies · 77 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Recovery of kidney function Unfractionated heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
Thrombocytopenia Unfractionated heparin vs low molecular weight heparin | RR 1.76 [0.61, 5.05] | 2 studies · 124 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Cost to health care services Unfractionated heparin vs low molecular weight heparin | no estimate extracted | NR | No studies |
Unfractionated heparin versus no pharmacological anticoagulation for continuous renal replacement therapy
Population: CRRT
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Major bleeding Unfractionated heparin vs no pharmacological anticoagulation | RR 0.5 [0.05, 4.67] | 1 study · 10 participants | Very low Downgraded: risk of bias, imprecision |
Death at 28 days Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Successful prevention of clotting Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Treatment cessation due of adverse events Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Recovery of kidney function Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Thrombocytopenia Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |
Cost to health care services Unfractionated heparin vs no pharmacological anticoagulation | no estimate extracted | NR | No studies |