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Journal of Nursing ›› 2019, Vol. 26 ›› Issue (2): 39-44.doi: 10.16460/j.issn1008-9969.2019.02.039

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Effectiveness of Sodium Citrate Solution and Heparin in Maintenance of Hemodialysis Catheters: A Meta Analysis

ZHU Ya-li1, YANG Chao2, FAN Xiang-hong3   

  1. 1. Dept. of Nursing Adminsitration, Minda Hospital Affiliated to Hubei University for Nationalities, Enshi 445000, China;
    2. School of Health Sciences, Wuhan University, Wuhan 430000, China;
    3. Dept. of Nursing Administration,Renmin Hospital of Wuhan University, Wuhan 430000, China
  • Received:2018-04-11 Online:2019-01-25 Published:2020-07-16

Abstract: Objective To evaluate the efficacy of sodium citrate solution and heparin in the maintenance of hemodialysis catheters. Methods We searched literatures in The Cochrane Library, Web of Science, CINAHL Complete, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Science and Technology periodical Database (VIP) from their inception to February 3, 2018 and papers from American Journal of Kidney Diseases Home,Chinese Journal of Kidney Diseases, and Kidney Dialysis and Kidney Transplant Journal from their first issue to February 3, 2018. Only randomized controlled trials (RCT) or quasi-experimental trials published in full-text papers were included. Revman 5.0 and Stata 12.0 software were used for meta analysis. Result Fifteen studies (1,485 patients) were included. The results indicated that the citrate sealing solution was obviously superior to the heparin sealing solution in reducing the incidence of bleeding [RR=0.22, 95%CI(0.12,0.41), P<0.01] and the frequency of thrombolytic therapy [RR=0.74, 95%CI(0.60,0.91),P<0.01]. We found the opposite results in the catheter infection between the two groups with different statistical units. There was no statistical significance in the comparison of the rate of thrombus occurrence, dysfunction resulting in extubation rate and mortality (P>0.5). Conclusion Compared with heparin, sodium citrate can reduce the incidence of hemorrhage and the times of thrombolytic therapy. Sodium citrate with medium solubility can obviously reduce the incidence of catheter infection. There is no significant difference in the rate of thrombus, extubation due to dysfunction, and mortality between the two groups.

Key words: hemodialysis catheter, heparin, sodium citrate, filling solution, Meta analysis

CLC Number: 

  • R459.5
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