Adverse Events in Hemodialysis Patients With Venous Catheters Locked With 30% Trisodium Citrate Versus Alternative Locking Solutions
Bibliographic record
Abstract
INTRODUCTION: Catheter locking solutions-including trisodium citrate-are crucial for maintaining central venous catheter patency in end-stage renal disease patients. Despite widespread usage, discrepancies remain regarding the safety profile of trisodium citrate. This study evaluates the safety of 30% trisodium citrate relative to alternative solutions in a large, heterogenous population. METHODS: We conducted a retrospective cohort study of 83,306 catheters from 51,243 patients at Fresenius Medical Care clinics across Europe, the Middle East, Africa, and Latin America from October 15, 2011 to 31 August 31, 2021. The 30% trisodium citrate group (10,689 patients) comprised all catheters routinely locked with 30% trisodium citrate. The control group (40,554 patients) included catheters locked with various non-trisodium citrate solutions, most commonly heparin, along with saline, gentamicin, and, less frequently, alteplase, antimicrobial caps (isopropyl alcohol or chlorhexidine), or taurolidine. Mean follow-up was 116 days. FINDINGS: Chi-square testing identified significant differences in three of four adverse event categories between the 30% trisodium citrate and control groups. The 30% trisodium citrate showed a favorable risk profile for Catheter and Procedure Issues (RR = 0.27, 95% CI: 0.25-0.28), Systemic Reactions and Symptoms (RR = 0.10, 95% CI: 0.09-0.11), and Thrombotic or Coagulation Complications (RR = 0.60, 95% CI: 0.58-0.61). No significant difference emerged for Infection-Related Events (RR = 1.02, 95% CI: 0.98-1.07). DISCUSSION: These results support the relative safety of 30% trisodium citrate as a locking solution in a large, diverse patient cohort. Further research should further explore how patient-level, catheter-level, and facility-level factors influence the comparative safety of locking solutions.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".