Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients
Background. Citrate has anticoagulative properties and favorable effects on inflammation, but it has the potential hazards of inducing hypocalcemia. Bicarbonate dialysate (BHD) replacing citrate for acetate is now used in chronic haemodialysis but has never been tested in postdilution online haemodi...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/703612 |
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| author | Vincenzo Panichi Enrico Fiaccadori Alberto Rosati Roberto Fanelli Giada Bernabini Alessia Scatena Francesco Pizzarelli |
| author_facet | Vincenzo Panichi Enrico Fiaccadori Alberto Rosati Roberto Fanelli Giada Bernabini Alessia Scatena Francesco Pizzarelli |
| author_sort | Vincenzo Panichi |
| collection | DOAJ |
| description | Background. Citrate has anticoagulative properties and favorable effects on inflammation, but it has the potential hazards of inducing hypocalcemia. Bicarbonate dialysate (BHD) replacing citrate for acetate is now used in chronic haemodialysis but has never been tested in postdilution online haemodiafiltration (OL-HDF). Methods. Thirteen chronic stable dialysis patients were enrolled in a pilot, short-term study. Patients underwent one week (3 dialysis sessions) of BHD with 0.8 mmol/L citrate dialysate, followed by one week of postdilution high volume OL-HDF with standard bicarbonate dialysate, and one week of high volume OL-HDF with 0.8 mmol/L citrate dialysate. Results. In citrate OL-HDF pretreatment plasma levels of C-reactive protein and β2-microglobulin were significantly reduced; intra-treatment plasma acetate levels increased in the former technique and decreased in the latter. During both citrate techniques (OL-HDF and HD) ionized calcium levels remained stable within the normal range. Conclusions. Should our promising results be confirmed in a long-term study on a wider population, then OL-HDF with citrate dialysate may represent a further step in improving dialysis biocompatibility. |
| format | Article |
| id | doaj-art-ffe6d343c8b74328be3a9052acc84c83 |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-ffe6d343c8b74328be3a9052acc84c832025-08-20T03:25:54ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/703612703612Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis PatientsVincenzo Panichi0Enrico Fiaccadori1Alberto Rosati2Roberto Fanelli3Giada Bernabini4Alessia Scatena5Francesco Pizzarelli6Nephrology and Dialysis Unit, Versilia Hospital, 55034 Lido Camaiore (Lucca), ItalyNephrology and Dialysis Unit, Parma Hospital, 43100 Parma, ItalyNephrology and Dialysis Unit, Lucca Hospital, 55100 Lucca, ItalyNephrology and Dialysis Unit, SM Annunziata Hospital, 50012 Florence, ItalyNephrology and Dialysis Unit, Versilia Hospital, 55034 Lido Camaiore (Lucca), ItalyNephrology and Dialysis Unit, Versilia Hospital, 55034 Lido Camaiore (Lucca), ItalyNephrology and Dialysis Unit, SM Annunziata Hospital, 50012 Florence, ItalyBackground. Citrate has anticoagulative properties and favorable effects on inflammation, but it has the potential hazards of inducing hypocalcemia. Bicarbonate dialysate (BHD) replacing citrate for acetate is now used in chronic haemodialysis but has never been tested in postdilution online haemodiafiltration (OL-HDF). Methods. Thirteen chronic stable dialysis patients were enrolled in a pilot, short-term study. Patients underwent one week (3 dialysis sessions) of BHD with 0.8 mmol/L citrate dialysate, followed by one week of postdilution high volume OL-HDF with standard bicarbonate dialysate, and one week of high volume OL-HDF with 0.8 mmol/L citrate dialysate. Results. In citrate OL-HDF pretreatment plasma levels of C-reactive protein and β2-microglobulin were significantly reduced; intra-treatment plasma acetate levels increased in the former technique and decreased in the latter. During both citrate techniques (OL-HDF and HD) ionized calcium levels remained stable within the normal range. Conclusions. Should our promising results be confirmed in a long-term study on a wider population, then OL-HDF with citrate dialysate may represent a further step in improving dialysis biocompatibility.http://dx.doi.org/10.1155/2013/703612 |
| spellingShingle | Vincenzo Panichi Enrico Fiaccadori Alberto Rosati Roberto Fanelli Giada Bernabini Alessia Scatena Francesco Pizzarelli Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients The Scientific World Journal |
| title | Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients |
| title_full | Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients |
| title_fullStr | Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients |
| title_full_unstemmed | Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients |
| title_short | Post-Dilution on Line Haemodiafiltration with Citrate Dialysate: First Clinical Experience in Chronic Dialysis Patients |
| title_sort | post dilution on line haemodiafiltration with citrate dialysate first clinical experience in chronic dialysis patients |
| url | http://dx.doi.org/10.1155/2013/703612 |
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