Stability of citrate and calcium dosing in citrate renal replacement therapy

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Stability of citrate and calcium dosing in citrate renal replacement therapy

Introduction Citrate is the recommended anticoagulant for continuous renal replacement therapy (RRT) [1], and is thought to confer numerous benefits, including more continuous hours of filtration, fewer total circuits used, less overall cost and maybe improved patient and kidney survival when compared with heparin anticoagulation [2]. Citrate is run pre filter, calcium is infused post filter, t...

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Citrate anticoagulation for continuous renal replacement therapy

Clinical Problem A 73 year old female patient presented to the Accident and Emergency Department (A&E) with a profound anaemia, acute kidney injury (AKI) and severe hyperkalaemia. She had a background of Chronic Obstructive Pulmonary Disease (COPD), osteoarthritis, hypertension, morbid obesity and a very poor functional status. She described a one week history of bleeding haemorrhoids. She was ...

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Optimizing citrate dose for regional anticoagulation in continuous renal replacement therapy: measuring citrate concentrations instead of ionized calcium?

Regular measurement of systemic and post-filter ionized calcium (iCa) concentrations is imperative to correctly handle regional citrate anticoagulation dose during continuous renal replacement therapy (CRRT). Keeping post-filter iCa within a tight range guarantees optimal circuit function and enhances filter life span [1, 2], whereas a decrease in plasma iCa, with subsequent elevation of the to...

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Citrate for continuous renal replacement therapy: safer, better and cheaper

In a previous issue of Critical Care, Schilder and colleagues report the results of their multicenter trial (Citrate Anticoagulation Versus Systemic Heparinization; CASH) comparing regional anticoagulation with citrate to heparin anticoagulation. They found that citrate was safer, more efficacious and cheaper than heparin. In contrast to the largest previous trial, however, a survival benefit w...

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Regional citrate anticoagulation for continuous renal replacement therapy without post-filter monitoring of ionized calcium

*Corresponding author: Tibor Fülöp, M.D., FACP, FASN, Division of Nephrology, University of Mississippi Medical Center, 2500 North State Street, L 504; Jackson, Mississippi 39216-4505. Present address of corresponding author: Department of Medicine Division of Nephrology, Medical University of South Carolina, Charleston, USA, Email: [email protected] http://journalrip.com DOI: 10.1517...

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ژورنال

عنوان ژورنال: Intensive Care Medicine Experimental

سال: 2015

ISSN: 2197-425X

DOI: 10.1186/2197-425x-3-s1-a63