Citrate versus Acetate-Based Dialysate in On-Line Haemodiafiltration. A Prospective Cross-Over Study

Abstract

Background and Aims: A bicarbonate dialysate acidified with citrate (CD) has been reported to have local anticoagulant effect and improves biocompatibility. This study examines the effect of CD on dialysis efficiency, coagulation, acid-base status, electrolytes, and inflammation in patients in on-line hemodiafiltration (OL-HDF). Methods: 35 patients in OL-HDF were enrolled in a prospective, cross-over study for a 24-week period and two phases alternating CD and acetate dialysate fluid (AD). Parameters on study were predialysis levels of bicarbonate and ionic calcium, reactive C Protein (CRP), and beta-2 microglobulin (B2MG) and postdialysis levels of activated tromboplastine time, bicarbonate, and ionized calcium. Results: No significant differences in coagulation parameters, pH, and predialysis bicarbonate were found. The postdialysis bicarbonate and postdialysis calcium were lower with CD. Dialysis efficiency was greater with CD. Regarding inflammatory parameters, both CRP and B2MG were lower using CD. Conclusion: The use of CD is safe and effective in OL-HDF, and it improves dialysis efficacy, postdialysis alkalosis, and inflammation.

Journal

Journal ID (publisher-id): BPU

Journal ID (nlm-ta): Blood Purif

Journal ID (doi): 10.1159/issn.0253-5068

Title: Blood Purification

Publisher: S. Karger AG

ISSN (Print): 0253-5068

ISSN (Electronic): 1421-9735

Publication date Subscription-year: 2015

Publication date (Print): May 2015

Publication date (Electronic): 10 March 2015

Volume: 39

Issue: 1-3

Pages: 181-187

Affiliations

Department of Nephrology, University Hospital Santa Lucia, Cartagena, Murcia, Spain

Author notes

*Manuel Molina Nuñez, Department of Nephrology, University Hospital Santa Lucia, C/Mezquita s/n, Paraje Los Arcos, ES-30202 Cartagena, Murcia (Spain), E-Mail [e-mail]

Article

Publisher ID: 371569 Other ID: Blood Purif 2015;39:181-187

DOI: 10.1159/000371569

PubMed ID: 25791278

Copyright statement: © 2015 S. Karger AG, Basel

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Page count

Figures: 3, Tables: 4, References: 32, Pages: 7

Product

Self URI (application/pdf): https://www.karger.com/Article/Pdf/371569

Self URI (text/html): https://www.karger.com/Article/FullText/371569

Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology

Categories

Subject: Original Paper