HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: CJN.02590409v1 4/9/1459    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Google Scholar Articles by Kossmann, R. J. Articles by Ahmad, S. PubMed PubMed Citation Articles by Kossmann, R. J. Articles by Ahmad, S. Related Collections Related Article

Increased Efficiency of Hemodialysis with Citrate Dialysate: A Prospective Controlled Study

Robert J. Kossmann^*, Annette Gonzales, Robin Callan, and Suhail Ahmad

^* Nephrophiles LLC, Santa Fe, New Mexico; Fresenius Medical Care, Santa Fe, New Mexico; Advanced Renal Technologies, Bellevue, Washington; and Department of Medicine, Scribner Kidney Center, University of Washington, Seattle, Washington

Correspondence: Dr. Suhail Ahmad, Scribner Kidney Center, 2150 North 107th Street, Suite 160, Seattle, WA 98133. Phone: 206-543-2095; Fax: 206-363-6146; E-mail: sahmad{at}u.washington.edu

Background and objectives: A bicarbonate dialysate acidified with citrate (CD) has been reported to have local anticoagulant effect. This study examines the effect of CD on dialysis efficiency, measured as eKt/Vurea, and predialysis concentrations of BUN, creatinine, phosphate, and β-2 microglobulin in chronic dialysis units.

Design, settings, participants, & measurements: Three outpatient chronic hemodialysis units with 142 patients were switched to CD for 6 mo. Using each patient's prior 6 mo on regular bicarbonate dialysate acidified by acetate (AD) as control, eKt/Vurea was compared with that of CD. Follow-up data for 7 mo after the study were collected from about one-half of the participants remaining on CD and the others returned to AD.

Results: eKt/Vurea, increased (P < 0.0001) from pre-CD value of 1.51 ± 0.01 to 1.57 ± 0.01 with CD. During CD use β-2 microglobulin levels declined (P = 0.0001) from 28.1 ± 10.0 to 25.9 ± 10.0. Similarly, the concentrations of BUN, creatinine, and phosphate also decreased on CD (P < 0.008). In the poststudy period, eKt/Vurea for the patients staying on CD remained unchanged at 1.60 ± 0.17 versus 1.59 ± 0.18 (P = NS), whereas in those returning to AD the eKt/Vurea decreased from 1.55 ± 0.20 to 1.52 ± 0.17 (P < 0.0001).

Conclusions: Data suggest that CD use is associated with increased solute removal.

Related Article

Dialysate ... Ho-Hum!

Thomas A. Golper and Richard A. Ward
Clin. J. Am. Soc. Nephrol. 2009 4: 1403-1404. [Full Text] [PDF]

This article has been cited by other articles:

				T. A. Golper and R. A. Ward Dialysate ... Ho-Hum! Clin. J. Am. Soc. Nephrol., September 1, 2009; 4(9): 1403 - 1404. [Full Text] [PDF]