| Increased efficiency of hemodialysis with citrate dialysate: a prospective controlled study. | |
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MedLine Citation:
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PMID: 19661218 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Robert J Kossmann; Annette Gonzales; Robin Callan; Suhail Ahmad |
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Publication Detail:
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Type: Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2009-08-06 |
Journal Detail:
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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:
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Created Date: 2009-09-04 Completed Date: 2009-11-23 Revised Date: 2010-09-02 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1459-64 Citation Subset: IM |
Affiliation:
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Nephrophiles LLC, Santa Fe, New Mexico, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acetic Acid
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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:
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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:
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Clin J Am Soc Nephrol. 2009 Sep;4(9):1403-4
[PMID:
19696215
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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