PMID- 26442902
OWN - NLM
STAT- MEDLINE
DCOM- 20170913
LR  - 20181202
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Linking)
VI  - 31
IP  - 8
DP  - 2016 Aug
TI  - Effects of citrate dialysate in chronic dialysis: a multicentre randomized 
      crossover study.
PG  - 1327-34
LID - 10.1093/ndt/gfv347 [doi]
AB  - BACKGROUND: Although citrate dialysate (CiDi) is regarded to be safe, dialysis 
      modalities using higher dialysate volumes, like haemodiafiltration (HDF), may 
      expose patients to higher citrate load and thus increase the risk of 
      complications. We investigated the residual risk of CiDi compared with standard 
      dialysate (StDi) in patients on different dialysis modalities and its effect on 
      dialysis dose. METHODS: In a multicentre randomized crossover study, 92 dialysis 
      patients (HDF post-dilution: n = 44, HDF pre-dilution: n = 26, haemodialysis: n = 
      25) were treated for 4 weeks with each dialysate (StDi and CiDi). Hypocalcaemia 
      (ionized calcium </=0.9 mmol/L), alkalosis (pH >/=7.55), post-treatment bicarbonate 
      >/=32 mmol/L, pre-treatment bicarbonate >/=27 mmol/L, intra-dialytic events (IEs) and 
      adverse events (AEs) between dialysis sessions were investigated as primary end 
      points. The secondary objective was dialysis efficacy, i.e. dose and removal 
      ratios of urea, creatinine, phosphate and beta-2-microglobulin. RESULTS: 
      Post-dialysis overcorrection of bicarbonate (>32 mmol/L) was less frequent with 
      CiDi (P = 0.008). Other predefined calcium and acid-base disturbances did not 
      vary. There was no significant difference in IE. However, more patients developed 
      AEs such as fatigue, muscle spasms or pain using CiDi (StDi: 41 versus CiDi: 55 
      patients, P = 0.02), particularly in the first 2 weeks of exposure. Dialysis 
      efficacy was comparable with both dialysates. CONCLUSIONS: It can be confirmed 
      that CiDi is not associated with the development of severe calcium and acid-base 
      disorders, even when dialysis modalities with higher citrate loads are used. 
      However, a refinement of the CiDi composition to minimize AEs is necessary.
CI  - (c) The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. 
      All rights reserved.
FAU - Schmitz, Michael
AU  - Schmitz M
AD  - Department of Nephrology and General Medicine, Stadtisches Klinikum Solingen 
      GmbH, Solingen, Germany.
FAU - Loke, Olaf
AU  - Loke O
AD  - Nephrologische Gemeinschaftspraxis Dialyse und Lipidapherese, Ludenscheid, 
      Germany.
FAU - Fach, Bernhard
AU  - Fach B
AD  - PHV Dialysezentrum, Wetzlar, Germany.
FAU - Kalb, Klaus
AU  - Kalb K
AD  - Markische Dialysezentren GmbH, Ludenscheid, Germany.
FAU - Heering, Peter J
AU  - Heering PJ
AD  - Department of Nephrology and General Medicine, Stadtisches Klinikum Solingen 
      GmbH, Solingen, Germany.
FAU - Meinke, Dirk
AU  - Meinke D
AD  - Nephrologische Gemeinschaftspraxis Dialyse und Lipidapherese, Ludenscheid, 
      Germany.
FAU - Rawer, Peter
AU  - Rawer P
AD  - PHV Dialysezentrum, Wetzlar, Germany.
FAU - Galle, Jan
AU  - Galle J
AD  - Markische Dialysezentren GmbH, Ludenscheid, Germany.
FAU - Kozik-Jaromin, Justyna
AU  - Kozik-Jaromin J
AD  - Clinical Research, Fresenius Medical Care, Bad Homburg, Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20151005
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Calcium Chelating Agents)
RN  - 0 (Dialysis Solutions)
RN  - 2968PHW8QP (Citric Acid)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Calcium Chelating Agents/pharmacology
MH  - Citric Acid/*pharmacology
MH  - Cross-Over Studies
MH  - Dialysis Solutions/*pharmacology
MH  - Female
MH  - Humans
MH  - Hypercalcemia/*prevention & control
MH  - Kidney Failure, Chronic/*therapy
MH  - Male
MH  - Middle Aged
MH  - Renal Dialysis/*methods
MH  - Treatment Outcome
OTO - NOTNLM
OT  - calcium
OT  - citrate
OT  - citrate dialysate
OT  - dialysis
OT  - haemodiafiltration
EDAT- 2015/10/08 06:00
MHDA- 2017/09/14 06:00
CRDT- 2015/10/08 06:00
PHST- 2015/06/02 00:00 [received]
PHST- 2015/08/30 00:00 [accepted]
PHST- 2015/10/08 06:00 [entrez]
PHST- 2015/10/08 06:00 [pubmed]
PHST- 2017/09/14 06:00 [medline]
AID - gfv347 [pii]
AID - 10.1093/ndt/gfv347 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2016 Aug;31(8):1327-34. doi: 10.1093/ndt/gfv347. Epub 
      2015 Oct 5.