20.500.12556/RUL-135718 Biocompatibility parameters with standard and increased dose of citrate in hemodialysis a randomized trial 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. biocompatibility complement system hemodialysis myeloperoxidase platelet factor 4 regional citrate anticoagulation thrombin–antithrombin complex biokompatibilnost hemodializa mieloperoksidaza antikoagulacija trombin-antitrombin kompleks true false true Angleški jezik Slovenski jezik Članek v reviji 2022-03-29 13:40:29 2022-03-29 13:40:29 2022-09-14 04:14:49 0000-00-00 00:00:00 2021 0 0 11 str. iss. 13, art. 2987 Vol. 10 2021 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 2077-0383 10.3390/jcm10132987 69247491 RAZ_Orsag_Alesa_2021.pdf RAZ_Orsag_Alesa_2021.pdf 1 07AC5A2E877C16DFBF70FB978A94329B 360aa6f9ad361b4501a0b9ffcd8ce9522561e9e53be81a99a73d2a9e95671687 40f375b6-af55-11ec-8aca-00155dcfd717 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=154974 https://www.mdpi.com/2077-0383/10/13/2987 1 04a427bd-af55-11ec-8aca-00155dcfd717 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=154973 Medicinska fakulteta 0 0 0