Biocompatibility Parameters with Standard and Increased Dose of Citrate in Hemodialysis—A Randomized Trial
| Autor: | Jakob Gubensek, Saša Simčič, Mojca Bozic-Mijovski, Alesa Orsag, Samo Hudoklin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Biocompatibility medicine.medical_treatment 030232 urology & nephrology Urology thrombin–antithrombin complex 030204 cardiovascular system & hematology Article law.invention 03 medical and health sciences 0302 clinical medicine biocompatibility Group differences Randomized controlled trial law medicine Citrate anticoagulation complement system Calcium metabolism hemodialysis biology business.industry General Medicine regional citrate anticoagulation platelet factor 4 myeloperoxidase Myeloperoxidase biology.protein Medicine Hemodialysis business Platelet factor 4 |
| Zdroj: | Journal of Clinical Medicine Journal of Clinical Medicine, Vol 10, Iss 2987, p 2987 (2021) Volume 10 Issue 13 |
| ISSN: | 2077-0383 |
| Popis: | Background: The dose of citrate needed in regional citrate anticoagulation (RCA) to achieve optimal biocompatibility is unknown. We performed a randomized trial comparing two doses (ACTRN12613001340729). Methods: In 30 patients a single hemodialysis with either standard (2.7 mmol/L) or increased dose of citrate (4 mmol/L) was performed. C5a-desArg, myeloperoxidase (MPO), thrombin-antithrombin complex (TAT), and platelet factor 4 (PF4) were measured and the inner surface of the dialyzer fibers was evaluated with scanning electron microscopy (SEM). Results: A good separation of anticoagulation effect was achieved (post-filter ionized calcium 0.20 vs. 0.31 mmol/L, p < 0.05). There was no effect of citrate dose on any of the biocompatibility parameters transient and parallel increase in PF4 after 30 min and parallel increase in TAT after 4 h were observed. There were no visually detected clotting problems within the circuit and no significant hypocalcemia in either group. SEM clotting score was excellent and comparable in both groups (p = 0.59). Conclusions: Given the excellent results in both groups, absence of between group differences and inability of the increased dose of citrate to completely blunt the small residual increase in PF4 and TAT, we conclude that the standard dose of citrate seems sufficient in RCA for chronic hemodialysis. |
| Databáze: | OpenAIRE |
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