A mathematical estimation for quantified calcium supplementation during intermittent hemodialysis using regional citrate anticoagulation.
calcium
clearance
creatinine
intermittent hemodialysis
phosphate
regional citrate anticoagulation
Journal
Artificial organs
ISSN: 1525-1594
Titre abrégé: Artif Organs
Pays: United States
ID NLM: 7802778
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
revised:
21
12
2021
received:
19
07
2021
accepted:
23
12
2021
pubmed:
4
1
2022
medline:
21
5
2022
entrez:
3
1
2022
Statut:
ppublish
Résumé
Regional citrate anticoagulation has been recommended as an alternative of anticoagulation for patients at high risk of bleeding undergoing intermittent hemodialysis. Precise calcium supplementation is important for the safety of regional citrate anticoagulation. In this study, we aimed to develop a possible method to optimize calcium supplementation for regional citrate anticoagulation in intermittent hemodialysis. The investigation consisted of a pilot study and a validation study. 18 patients undergoing intermittent hemodialysis anticoagulated by citrate, and six types of filters were included in the pilot study. The ionized calcium levels were monitored and maintained in the targeted range. Calcium-free dialysate was used in the study. After linear regression analysis of the clearance of non-protein bound calcium and calculating the ratio of the non-protein bound calcium concentration to total calcium concentration, we developed a mathematical model for estimation of extracorporeal circuit calcium removal. Another 8 maintenance hemodialysis patients (12 sessions) were enrolled in the validation study to validate the new version of the calcium supplementation approach. In the pilot study, positive correlations were found between the clearance of non-protein bound calcium and the hematocrit-adjusted clearance of creatinine and phosphate given in the dialyzer leaflet (R We developed a possible method to quantify calcium supplementation for intermittent hemodialysis anticoagulated by citrate which may help to avoid negative calcium balance and reduce the incidence of complications.
Sections du résumé
BACKGROUND
BACKGROUND
Regional citrate anticoagulation has been recommended as an alternative of anticoagulation for patients at high risk of bleeding undergoing intermittent hemodialysis. Precise calcium supplementation is important for the safety of regional citrate anticoagulation. In this study, we aimed to develop a possible method to optimize calcium supplementation for regional citrate anticoagulation in intermittent hemodialysis.
METHODS
METHODS
The investigation consisted of a pilot study and a validation study. 18 patients undergoing intermittent hemodialysis anticoagulated by citrate, and six types of filters were included in the pilot study. The ionized calcium levels were monitored and maintained in the targeted range. Calcium-free dialysate was used in the study. After linear regression analysis of the clearance of non-protein bound calcium and calculating the ratio of the non-protein bound calcium concentration to total calcium concentration, we developed a mathematical model for estimation of extracorporeal circuit calcium removal. Another 8 maintenance hemodialysis patients (12 sessions) were enrolled in the validation study to validate the new version of the calcium supplementation approach.
RESULTS
RESULTS
In the pilot study, positive correlations were found between the clearance of non-protein bound calcium and the hematocrit-adjusted clearance of creatinine and phosphate given in the dialyzer leaflet (R
CONCLUSIONS
CONCLUSIONS
We developed a possible method to quantify calcium supplementation for intermittent hemodialysis anticoagulated by citrate which may help to avoid negative calcium balance and reduce the incidence of complications.
Substances chimiques
Anticoagulants
0
Citrates
0
Citric Acid
2968PHW8QP
Calcium
SY7Q814VUP
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1122-1131Subventions
Organisme : Shanghai Ninth People's Hospital Clinical Research Program
ID : JYLJ007
Organisme : Science & Technology Innovation fund of Shanghai Ninth People's Hospital
ID : CK2019010
Organisme : National Natural Science Foundation of China
ID : 81470990
Organisme : National Natural Science Foundation of China
ID : 81870462
Organisme : Science and Technology Commission of Shanghai Municipality
ID : 17441904200
Organisme : Science and Technology Commission of Shanghai Municipality
ID : 19441909300
Informations de copyright
© 2022 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.
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