Document Detail


Increased efficiency of hemodialysis with citrate dialysate: a prospective controlled study.
MedLine Citation:
PMID:  19661218     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: A bicarbonate dialysate acidified with citrate (CD) has been reported to have local anticoagulant effect. This study examines the effect of CD on dialysis efficiency, measured as eKt/Vurea, and predialysis concentrations of BUN, creatinine, phosphate, and beta-2 microglobulin in chronic dialysis units.
DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: Three outpatient chronic hemodialysis units with 142 patients were switched to CD for 6 mo. Using each patient's prior 6 mo on regular bicarbonate dialysate acidified by acetate (AD) as control, eKt/Vurea was compared with that of CD. Follow-up data for 7 mo after the study were collected from about one-half of the participants remaining on CD and the others returned to AD.
RESULTS: eKt/Vurea, increased (P < 0.0001) from pre-CD value of 1.51 +/- 0.01 to 1.57 +/- 0.01 with CD. During CD use beta-2 microglobulin levels declined (P = 0.0001) from 28.1 +/- 10.0 to 25.9 +/- 10.0. Similarly, the concentrations of BUN, creatinine, and phosphate also decreased on CD (P < 0.008). In the poststudy period, eKt/Vurea for the patients staying on CD remained unchanged at 1.60 +/- 0.17 versus 1.59 +/- 0.18 (P = NS), whereas in those returning to AD the eKt/Vurea decreased from 1.55 +/- 0.20 to 1.52 +/- 0.17 (P < 0.0001).
CONCLUSIONS: Data suggest that CD use is associated with increased solute removal.
Authors:
Robert J Kossmann; Annette Gonzales; Robin Callan; Suhail Ahmad
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-08-06
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  4     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-04     Completed Date:  2009-11-23     Revised Date:  2013-06-02    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1459-64     Citation Subset:  IM    
Affiliation:
Nephrophiles LLC, Santa Fe, New Mexico, USA.
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MeSH Terms
Descriptor/Qualifier:
Acetic Acid / therapeutic use*
Aged
Ambulatory Care
Anticoagulants / therapeutic use*
Bicarbonates / therapeutic use*
Biological Markers / blood
Blood Coagulation / drug effects*
Blood Urea Nitrogen
Citric Acid / therapeutic use*
Creatinine / blood
Dialysis Solutions / therapeutic use*
Female
Humans
Kinetics
Male
Middle Aged
Phosphates / blood
Prospective Studies
Renal Dialysis*
Treatment Outcome
United States
beta 2-Microglobulin / blood
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Bicarbonates; 0/Biological Markers; 0/Dialysis Solutions; 0/Phosphates; 0/beta 2-Microglobulin; 60-27-5/Creatinine; 64-19-7/Acetic Acid; 77-92-9/Citric Acid
Comments/Corrections
Comment In:
Clin J Am Soc Nephrol. 2009 Sep;4(9):1403-4   [PMID:  19696215 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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