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Biocompatibility parameters with standard and increased dose of citrate in hemodialysis : a randomized trial
ID
Orsag, Aleša
(
Author
),
ID
Božič, Mojca
(
Author
),
ID
Hudoklin, Samo
(
Author
),
ID
Simčič, Saša
(
Author
),
ID
Gubenšek, Jakob
(
Author
)
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MD5: 07AC5A2E877C16DFBF70FB978A94329B
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https://www.mdpi.com/2077-0383/10/13/2987
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Abstract
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.
Language:
English
Keywords:
biocompatibility
,
complement system
,
hemodialysis
,
myeloperoxidase
,
platelet factor 4
,
regional citrate anticoagulation
,
thrombin–antithrombin complex
Work type:
Article
Typology:
1.01 - Original Scientific Article
Organization:
MF - Faculty of Medicine
Publication status:
Published
Publication version:
Version of Record
Year:
2021
Number of pages:
11 str.
Numbering:
Vol. 10, iss. 13, art. 2987
PID:
20.500.12556/RUL-135718
UDC:
616.1
ISSN on article:
2077-0383
DOI:
10.3390/jcm10132987
COBISS.SI-ID:
69247491
Publication date in RUL:
29.03.2022
Views:
1508
Downloads:
108
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Record is a part of a journal
Title:
Journal of clinical medicine
Shortened title:
J. clin. med.
Publisher:
MDPI
ISSN:
2077-0383
COBISS.SI-ID:
5405759
Licences
License:
CC BY 4.0, Creative Commons Attribution 4.0 International
Link:
http://creativecommons.org/licenses/by/4.0/
Description:
This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:
04.07.2021
Secondary language
Language:
Slovenian
Keywords:
biokompatibilnost
,
hemodializa
,
mieloperoksidaza
,
antikoagulacija
,
trombin-antitrombin kompleks
Projects
Funder:
ARRS - Slovenian Research Agency
Project number:
P3-0323
Name:
Ledvične bolezni in nadomestna zdravljenja
Funder:
Other - Other funder or multiple funders
Funding programme:
University Medical Center Ljubljana
Project number:
20180054
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