Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study
Aim. To assess the tolerance of citrate accumulation due to plasma exchange (PE) among patients with acute-on-chronic liver failure (ACLF). Methods. A prospective, observational study was conducted among patients with ACLF who received heparin anticoagulation during PE-centered therapy without filtr...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/4909742 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562003222200320 |
|---|---|
| author | Yuanji Ma Yan Xu Fang Chen Ying Wang Lang Bai Hong Tang |
| author_facet | Yuanji Ma Yan Xu Fang Chen Ying Wang Lang Bai Hong Tang |
| author_sort | Yuanji Ma |
| collection | DOAJ |
| description | Aim. To assess the tolerance of citrate accumulation due to plasma exchange (PE) among patients with acute-on-chronic liver failure (ACLF). Methods. A prospective, observational study was conducted among patients with ACLF who received heparin anticoagulation during PE-centered therapy without filtration and dialysis. Citrate accumulation was defined as the value of total calcium (Catot) to ionized calcium (Caion) ratio (Catot/Caion) greater than or equal to 2.5 (Catot/Caion≥2.5). Results. Fifty-four patients were enrolled. The mean age and MELD score were 50.0 ± 11.3 years old and 25 ± 7, respectively. Thirty-three patients had liver cirrhosis. The total 3-month survival rate was 57.4% (31/54). The mean Catot/Caion at the time before PE was 2.05 ± 0.14. Catot/Caion≥2.5 occurred in 100.0% (54/54) and 29.6% (16/54) of patients with mean Catot/Caion of 4.34 ± 1.52 and 2.36 ± 0.32 immediately after PE and 1 hour after PE, respectively, and these levels were much higher than those before PE (p<0.01). However, all values returned to lower than 2.5 by the next morning with no difference from those before PE (2.10 ± 0.14 versus 2.05 ± 0.14, p>0.05). Hypocalcemia (ionized calcium) and mild alkalosis were the main metabolic alterations. No symptoms associated with hypocalcemia occurred. Conclusions. Citrate accumulation is well tolerated by patients with ACLF who receive PE-centered therapy without filtration and dialysis. This study is regeristed with ChiCTR-OOC-17013618. |
| format | Article |
| id | doaj-art-beabd96455584c8595e408b5eb8f9429 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-beabd96455584c8595e408b5eb8f94292025-02-03T01:23:38ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/49097424909742Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational StudyYuanji Ma0Yan Xu1Fang Chen2Ying Wang3Lang Bai4Hong Tang5Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, ChinaCenter of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, ChinaAim. To assess the tolerance of citrate accumulation due to plasma exchange (PE) among patients with acute-on-chronic liver failure (ACLF). Methods. A prospective, observational study was conducted among patients with ACLF who received heparin anticoagulation during PE-centered therapy without filtration and dialysis. Citrate accumulation was defined as the value of total calcium (Catot) to ionized calcium (Caion) ratio (Catot/Caion) greater than or equal to 2.5 (Catot/Caion≥2.5). Results. Fifty-four patients were enrolled. The mean age and MELD score were 50.0 ± 11.3 years old and 25 ± 7, respectively. Thirty-three patients had liver cirrhosis. The total 3-month survival rate was 57.4% (31/54). The mean Catot/Caion at the time before PE was 2.05 ± 0.14. Catot/Caion≥2.5 occurred in 100.0% (54/54) and 29.6% (16/54) of patients with mean Catot/Caion of 4.34 ± 1.52 and 2.36 ± 0.32 immediately after PE and 1 hour after PE, respectively, and these levels were much higher than those before PE (p<0.01). However, all values returned to lower than 2.5 by the next morning with no difference from those before PE (2.10 ± 0.14 versus 2.05 ± 0.14, p>0.05). Hypocalcemia (ionized calcium) and mild alkalosis were the main metabolic alterations. No symptoms associated with hypocalcemia occurred. Conclusions. Citrate accumulation is well tolerated by patients with ACLF who receive PE-centered therapy without filtration and dialysis. This study is regeristed with ChiCTR-OOC-17013618.http://dx.doi.org/10.1155/2018/4909742 |
| spellingShingle | Yuanji Ma Yan Xu Fang Chen Ying Wang Lang Bai Hong Tang Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study Canadian Journal of Gastroenterology and Hepatology |
| title | Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study |
| title_full | Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study |
| title_fullStr | Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study |
| title_full_unstemmed | Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study |
| title_short | Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study |
| title_sort | good tolerance of citrate accumulation due to plasma exchange among patients with acute on chronic liver failure a prospective observational study |
| url | http://dx.doi.org/10.1155/2018/4909742 |
| work_keys_str_mv | AT yuanjima goodtoleranceofcitrateaccumulationduetoplasmaexchangeamongpatientswithacuteonchronicliverfailureaprospectiveobservationalstudy AT yanxu goodtoleranceofcitrateaccumulationduetoplasmaexchangeamongpatientswithacuteonchronicliverfailureaprospectiveobservationalstudy AT fangchen goodtoleranceofcitrateaccumulationduetoplasmaexchangeamongpatientswithacuteonchronicliverfailureaprospectiveobservationalstudy AT yingwang goodtoleranceofcitrateaccumulationduetoplasmaexchangeamongpatientswithacuteonchronicliverfailureaprospectiveobservationalstudy AT langbai goodtoleranceofcitrateaccumulationduetoplasmaexchangeamongpatientswithacuteonchronicliverfailureaprospectiveobservationalstudy AT hongtang goodtoleranceofcitrateaccumulationduetoplasmaexchangeamongpatientswithacuteonchronicliverfailureaprospectiveobservationalstudy |