Q: What is the advantage of the use of regional citrate in acute kidney injury (AKI) over other modes of anticoagulation? 

 Answer: Regional citrate has shown to increase the chances of kidneys to recover from acute injury. Exact mechanism is not confirmed but probably it is due to ability of citrate to reduce inflammation by inhibiting calcium-dependent activation of neutrophils and platelets.


References:

1. Gritters M, Grooteman MP, Schoorl M, et al. Citrate anticoagulation abolishes degranulation of polymorphonuclear cells and platelets and reduces oxidative stress during haemodialysis. Nephrol Dial Transplant 2006; 21:153. 

2. Böhler J, Schollmeyer P, Dressel B, et al. Reduction of granulocyte activation during hemodialysis with regional citrate anticoagulation: dissociation of complement activation and neutropenia from neutrophil degranulation. J Am Soc Nephrol 1996; 7:234.