heparin + citrate

Heparin + citrate is a combination anticoagulant formulation used primarily to prevent clotting in extracorporeal circuits such as during dialysis, apheresis, and continuous renal replacement therapy (CRRT). - **Heparin** is an anticoagulant that works by increasing the activity of antithrombin, which inhibits thrombin and other serine proteases involved in blood clotting. It prevents formation and extension of clots but does not dissolve existing clots. It is widely used for thromboprophylaxis, treatment of venous thromboembolism, prevention of clotting during surgeries including cardiac surgery, dialysis procedures, and maintenance of catheter patency. - **Citrate** acts as an anticoagulant by chelating calcium ions (Ca2+), which are essential cofactors in multiple steps of the coagulation cascade. Citrate provides regional anticoagulation mainly within the extracorporeal circuit with rapid systemic clearance. It is preferred for many apheresis procedures due to its safety profile compared to heparin. The combination leverages both mechanisms—heparin’s systemic inhibition of coagulation factors and citrate’s local calcium chelation—to reduce clotting risk effectively while potentially minimizing bleeding complications associated with higher doses of either agent alone. This combination has been shown especially useful in pediatric CRRT patients with elevated D-dimer levels to prolong filter lifespan without increasing bleeding risk.

Other names

heparin and citrate