Abstract: Objective  To investigate and evaluate the efficacy and safety of regional citrate anticoagulation continuous venovenous hemodiafiltration (RCA-CVVHDF) with calcium-containing dialysate and replacement solution.  Methods  The efficacy and safety of RCA-CVVHDF with calcium-containing dialysate and replacement solution performed in The 940th Hospital of Joint Logistics Support Force of Chinese PLA between Jul 1, 2021 and December 31, 2021 were retrospectively studied. Their CVVHDF operational characteristics, circuit outcomes and new-onset metabolic complications after RCA-CVVHDF with calcium-containing dialysate and replacement solution were analyzed.  Results   A total of 56 patients, 139 filters and 213 days of CRRT were analyzed. In the 56 patients, 43 were males (76.5%) and 13 were females (23.5%), with the average age of 59.6±20.8 years old (18-99 years old) The median filter life was 35±23h (6～72h), and filter life ≤24h, 25～48h, 49～72h and ≥72h were found in 37.4%, 34.5%, 17.3% and 10.8% respectively of the filters. Mild-to-moderate hypocalcemia and hyponatremia were observed in 18.0 and 5.0 per 100 CRRT days, respectively, but severe hypocalcemia, hyponatremia and any types of hypercalcemia and hypernatremia were not observed. Citrate accumulation was observed in 2.0 per 100 CRRT days, and metabolic acidosis occurred in 8.0 per 100 CRRT days. Conclusions   Under close monitoring, RCA-CVVHDF with calcium-containing dialysate and replacement solution can be effective and safe. This method is worth for further clinical practice.

Key words: Regional citrate anticoagulation, Continuous renal replace therapy, Hemofiltration basic replacement solution