Advantages
Disadvantages
No / Mechanical Anticoagulation
- Reduced bleeding risk
- ↓ cost
- ↑ risk of filter clotting:
- Shorter filter lifespan
- Reduced adequacy of RRT
- Not suitable for patients with HIT who are pro-thrombotic
Unfractionated Heparin
- Easily titratable
- Easily monitored
- Can be reversed with protamine
- ↑ bleeding risk
- Risk of HIT
LMWH
- ↓ cost
- ↑ familiarity
- ↑ bleeding risk
- Not titratable
- No reversal agent
Prostacyclin
- Reduced bleeding risk
- Shorter filter life
- Causes systemic hypotension
Citrate
- Good regional anticoagulation with reversal by calcium
- Reduced bleeding risk
- Associated with metabolic complications (Hypernatraemia, hypocalcaemia, metabolic alkalosis)
- Special dialysate required
- Contraindicated in liver failure
- Labour intensive