A Retrospective Study of Continuous Renal Therapy and Anticoagulation in Patients with Hemorrhagic Fever with Renal Syndrome

Abstract

Objective To observe the application of continuous renal replacement therapy (CRRT) and heparin anticoagulation in patients with HFRS, and to explore a more suitable anticoagulant strategy. Methods Eighty-five severe-type patients (severe group) and 71 critical-type patients (critical group) were enrolled in this study. The frequency of CRRT was compared between the two groups; the frequency of CRRT treated with and without heparin anticoagulation and the frequency of hemorrhage and channel blood clotting induced by the two anticoagulant strategies were observed. Results The frequency of CRRT in the critical group was higher than that in the severe group (P ＜ 0.001). The frequency of CRRT initiated during the overlapping phases in the critical group was significantly higher than that of the severe group (P = 0.032). The total times of CRRT was 103, and 70 of them were treated with heparin anticoagulation. The frequencies of hemorrhage induced by heparin anticoagulation and no heparinization were 16 and 0, respectively, and the frequencies of channel blood clotting were 2 and 4, respectively. Conclusions CRRT has been used extensively in the critical-type patients with HFRS. The heparin anticoagulation and no anticoagulant strategies should be used more rationally in patients treated with CRRT, according to the clinical characteristics of the disease.

Expert Consensus on the Prevention and Treatment of Hemorrhagic Fever with Renal Syndrome

“…For patients with a severe coagulation disorder, either citrate anticoagulation in vitro or no anticoagulant regimen is recommended. [76] Arterial blood gas, complete blood count, renal function, electrolytes, and coagulation parameters should be monitored regularly during CRRT.…”