Biocompatibility parameters with standard and increased dose of citrate in hemodialysis : a randomized trial

Orsag, Aleša (avtor), Božič, Mojca (avtor), Hudoklin, Samo (avtor), Simčič, Saša (avtor), Gubenšek, Jakob (avtor)

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.

• Jezik: Angleški jezik
• Ključne besede: biocompatibility, complement system, hemodialysis, myeloperoxidase, platelet factor 4, regional citrate anticoagulation, thrombin–antithrombin complex
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2021
• Št. strani: 11 str.
• Številčenje: Vol. 10, iss. 13, art. 2987
• PID: 20.500.12556/RUL-135718
• UDK: 616.1
• ISSN pri članku: 2077-0383
• DOI: 10.3390/jcm10132987
• COBISS.SI-ID: 69247491
• Datum objave v RUL: 29.03.2022

Gradivo je del revije

• Naslov: Journal of clinical medicine
• Skrajšan naslov: J. clin. med.
• Založnik: MDPI
• ISSN: 2077-0383
• COBISS.SI-ID: 5405759

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.
• Začetek licenciranja: 04.07.2021

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: biokompatibilnost, hemodializa, mieloperoksidaza, antikoagulacija, trombin-antitrombin kompleks

Projekti

• Financer: ARRS - Agencija za raziskovalno dejavnost Republike Slovenije
• Številka projekta: P3-0323
• Naslov: Ledvične bolezni in nadomestna zdravljenja

• Financer: Drugi - Drug financer ali več financerjev
• Program financ.: University Medical Center Ljubljana
• Številka projekta: 20180054