Regional citrate anticoagulation with continuous renal replacement therapy as a cause of hypercalcemia.
Continuous renal replacement therapy
Hypercalcemia
Regional citrate anticoagulation
Journal
Archives of osteoporosis
ISSN: 1862-3514
Titre abrégé: Arch Osteoporos
Pays: England
ID NLM: 101318988
Informations de publication
Date de publication:
24 Aug 2024
24 Aug 2024
Historique:
received:
31
03
2024
accepted:
26
07
2024
medline:
24
8
2024
pubmed:
24
8
2024
entrez:
24
8
2024
Statut:
epublish
Résumé
Awareness of the causes of hypercalcemia is essential for timely diagnosis of calcium disorders and optimal treatment. Citrate is commonly used as an anticoagulant during continuous renal replacement therapy (CRRT). Accumulation of citrate in the systemic circulation during CRRT may induce several metabolic disturbances, including total hypercalcemia and ionized hypocalcemia. The aim of the present study is to increase awareness of citrate accumulation and toxicity as a cause of hypercalcemia by relating three cases and reviewing the pathophysiology and clinical implications. We utilized electronic health records to examine the clinical cases and outlined key studies to review the consequences of citrate toxicity and general approaches to management. Citrate toxicity is associated with high mortality. A safe threshold for tolerating hypercalcemia during citrate anticoagulation is not clearly defined, and whether citrate toxicity independently increases mortality has not been resolved. Greater attention to citrate toxicity as a cause of hypercalcemia may lead to earlier detection, help to optimize the management of systemic calcium levels, and foster interest in future clinical studies.
Identifiants
pubmed: 39180669
doi: 10.1007/s11657-024-01434-y
pii: 10.1007/s11657-024-01434-y
doi:
Substances chimiques
Anticoagulants
0
Citric Acid
2968PHW8QP
Calcium
SY7Q814VUP
Types de publication
Journal Article
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
78Subventions
Organisme : NIDDK NIH HHS
ID : T32 DK007217
Pays : United States
Organisme : NIDDK NIH HHS
ID : 5K12DK122550
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30DK116074
Pays : United States
Informations de copyright
© 2024. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.
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