Regional citrate anticoagulation for hemodialysis: calcium-free vs. calcium containing dialysate - a randomized trial
| Autor: | Senka Černe, Jadranka Buturović-Ponikvar, Jakob Gubensek, Rafael Ponikvar |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Biomedical Engineering Metabolic alkalosis Medicine (miscellaneous) chemistry.chemical_element Bioengineering 030204 cardiovascular system & hematology Calcium law.invention Biomaterials Hemodialysis Solutions 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Renal Dialysis Medicine Citrate anticoagulation Humans Citrates Blood Coagulation Aged Aged 80 and over business.industry Anticoagulants General Medicine Middle Aged medicine.disease Surgery chemistry Anesthesia Female Hemodialysis business |
| Zdroj: | Europe PubMed Central |
| ISSN: | 0391-3988 |
| Popis: | Background The majority of citrate protocols for hemodialysis (HD) use calcium (Ca)-free dialysate, a limited number use dialysate with Ca, aiming to simplify the procedure. This randomized clinical study sought to compare the anticoagulant effect of citrate using Ca-free dialysate and dialysate with Ca 1.25 mmol/L. Methods Fifty HD procedures (in 5 chronic HD patients treated by chronic citrate anticoagulation) were randomly assigned to Ca-free dialysate (25 procedures) or Ca-1.25 dialysate (25 procedures), both with Mg 0.5 mmol/L, Na 138 mmol/L, and bicarbonate 28 mmol/L. Ca-free HD: 15% Na3 citrate 80 ml/hour was infused into the arterial line, and 1 M CaCl2, 14 ml/hour into the venous line. Ca-1.25 group: 15% Na3 citrate 100 ml/hour, 1 M CaCl2 2–4 ml/hour. Polyflux H dialyzers were used. Antithrombotic effect was assessed visually after HD at 3 points: dialyzer, arterial, and venous bubble traps, using a score of 5 (no clotting) to 1 (total clotting). Results Ca-free group: arterial bubble trap score 4.7 ± 0.5, dialyzer 4.5 ± 0.6, venous bubble trap 4.8 ± 0.6. Ionized calcium (iCa) at dialyzer inlet 0.34 ± 0.17, outlet 0.21 ± 0.06 mmol/L. All HDs were completed successfully. Ca-1.25 group: arterial bubble trap score 4.7 ± 0.5 (NS), dialyzer 2.6 ± 1.04 (pConclusion Citrate anticoagulation with Ca-1.25 dialysate resulted in significantly worse anticoagulation of dialyzer and venous bubble trap compared with Ca-free dialysate, despite higher citrate dose. |
| Databáze: | OpenAIRE |
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