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10.1186/s40697-015-0040-2 http://scihub22266oqcxt.onion/10.1186/s40697-015-0040-2 C4413999!4413999!25926995     free     free     free Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Can+J+Kidney+Health+Dis 2015 ; 2 (ä): ä Nephropedia Template TP {{tp|p=25926995|t=2015. Benefits and harms of citrate locking solutions for hemodialysis catheters: a systematic review and meta-analysis |pdf=|usr=}}{{25926995}} gab.com Text Benefits and harms of citrate locking solutions for hemodialysis catheters: a systematic review and meta-analysis JO: Can J Kidney Health Dis http://www.kidney.de/pget.php?&tw=1&pmid=25926995 #FOAvip Background: Citrate has theoretical advantages over heparin for locking hemodialysis central venous catheters (CVCs), but the comparative effectiveness of these agents is not clear. Objectives: 1) To compare the benefits and harms of citrate versus heparin locking solutions among patients undergoing hemodialysis through CVCs; 2) to appraise methodological quality of the supporting evidence. Data sources: CENTRAL, MEDLINE, EMBASE, CINAHL, ISI Web of Science, and nephrology conference abstracts. Study eligibility, participants, and interventions: We included randomized, parallel arm clinical trials that enrolled adult patients (>18 years) receiving chronic hemodialysis through CVCs using a citrate locking solution. We excluded studies in which citrate was combined with other agents, such as antibiotics. Appraisal and synthesis methods: We used the GRADE approach to systematic reviews and quality appraisal. Two reviewers performed data extraction independently and in duplicate. We pooled count data using generic inverse variance with random-effects models, and used fixed-effect models when only two studies were available for pooling. Subgroups included low (?5%) vs. higher (?30%) citrate. Results: We screened 600 citations. Forty-one proceeded to full-text screen; 5 met inclusion criteria. Studies included between 19 and 291 participants (Median N?=?61) followed for a total of 174.6 catheter-years; 2 were multi-centred trials. Three studies assessed all-cause mortality; the pooled relative risk for death was 0.71 (95% CI?=?0.42-1.24; p?=?0.21; I2?=?0%). The rate ratio for bacteremic episodes was 0.54 (95% CI?=?0.23-1.29; p?=?0.16; I2?=?65%) while the rate ratio for bleeding was 0.48 (95% CI?=?0.3-0.75; p?=?0.001;I I2?=?5%). Rates of catheter exchange/replacement, all-cause hospitalization and in-situ thrombolysis were not significantly different between groups in any of the pooled analyses. Risk of bias within pooled studies was low. Limitations: Outcome definitions varied across studies. Imprecision due to small sample sizes and low event rates reduce our overall confidence in the pooled effect estimates. Implications: Benefits and harms of citrate vs. heparin locking solutions remain unclear; larger studies and standardization of outcome measurement and reporting are warranted. Trial registration: Protocol Registration Number: CRD42013004781 Electronic supplementary material: The online version of this article (doi:10.1186/s40697-015-0040-2) contains supplementary material, which is available to authorized users. Twit Text FOAVip Benefits and harms of citrate locking solutions for hemodialysis catheters: a systematic review and meta-analysis ????Can J Kidney Health Dis http://www.kidney.de/pget.php?&tw=1&pmid=25926995 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25926995 #FOAvip English Wikipedia <ref>{{Cite pmid|25926995}}</ref> Benefits and harms of citrate locking solutions for hemodialysis catheters: a systematic review and meta-analysis #MMPMID25926995 Grudzinski A; Agarwal A; Bhatnagar N; Nesrallah G Can J Kidney Health Dis 2015[]; 2 (ä): ä PMID25926995show ga Background: Citrate has theoretical advantages over heparin for locking hemodialysis central venous catheters (CVCs), but the comparative effectiveness of these agents is not clear. Objectives: 1) To compare the benefits and harms of citrate versus heparin locking solutions among patients undergoing hemodialysis through CVCs; 2) to appraise methodological quality of the supporting evidence. Data sources: CENTRAL, MEDLINE, EMBASE, CINAHL, ISI Web of Science, and nephrology conference abstracts. Study eligibility, participants, and interventions: We included randomized, parallel arm clinical trials that enrolled adult patients (>18 years) receiving chronic hemodialysis through CVCs using a citrate locking solution. We excluded studies in which citrate was combined with other agents, such as antibiotics. Appraisal and synthesis methods: We used the GRADE approach to systematic reviews and quality appraisal. Two reviewers performed data extraction independently and in duplicate. We pooled count data using generic inverse variance with random-effects models, and used fixed-effect models when only two studies were available for pooling. Subgroups included low (?5%) vs. higher (?30%) citrate. Results: We screened 600 citations. Forty-one proceeded to full-text screen; 5 met inclusion criteria. Studies included between 19 and 291 participants (Median N?=?61) followed for a total of 174.6 catheter-years; 2 were multi-centred trials. Three studies assessed all-cause mortality; the pooled relative risk for death was 0.71 (95% CI?=?0.42-1.24; p?=?0.21; I2?=?0%). The rate ratio for bacteremic episodes was 0.54 (95% CI?=?0.23-1.29; p?=?0.16; I2?=?65%) while the rate ratio for bleeding was 0.48 (95% CI?=?0.3-0.75; p?=?0.001;I I2?=?5%). Rates of catheter exchange/replacement, all-cause hospitalization and in-situ thrombolysis were not significantly different between groups in any of the pooled analyses. Risk of bias within pooled studies was low. Limitations: Outcome definitions varied across studies. Imprecision due to small sample sizes and low event rates reduce our overall confidence in the pooled effect estimates. Implications: Benefits and harms of citrate vs. heparin locking solutions remain unclear; larger studies and standardization of outcome measurement and reporting are warranted. Trial registration: Protocol Registration Number: CRD42013004781 Electronic supplementary material: The online version of this article (doi:10.1186/s40697-015-0040-2) contains supplementary material, which is available to authorized users. äBenefits and harms of citrate locking solutions for hemodialysis cathe(epmc).pdf DeepDyve Pubget Overpricing