Treatment of metabolic alkalosis during continuous renal replacement therapy with regional citrate anticoagulation

The use of citrate as an anticoagulant in continuous renal replacement therapy is an effective method to achieve regional anticoagulation of the extracorporeal blood circuit and to avoid systemic anticoagulation. This allows bleeding complications to be reduced and filter life time to be prolonged....

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Bibliographic Details
Published in:International journal of artificial organs 2008-04, Vol.31 (4), p.363-366
Main Authors: Kindgen-Milles, D, Amman, J, Kleinekofort, W, Morgera, S
Format: Article
Language:English
Subjects:
Acid-Base Equilibrium
Acute Kidney Injury - metabolism
Acute Kidney Injury - physiopathology
Acute Kidney Injury - therapy
Aged
Alkalosis - chemically induced
Alkalosis - metabolism
Alkalosis - physiopathology
Alkalosis - therapy
Anticoagulants - administration & dosage
Anticoagulants - adverse effects
Anticoagulants - metabolism
Bicarbonates - blood
Citrates - administration & dosage
Citrates - adverse effects
Citrates - metabolism
Hemodialysis Solutions - administration & dosage
Humans
Hydrogen-Ion Concentration
Liver - metabolism
Male
Regional Blood Flow
Renal Dialysis
Time Factors
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Summary:The use of citrate as an anticoagulant in continuous renal replacement therapy is an effective method to achieve regional anticoagulation of the extracorporeal blood circuit and to avoid systemic anticoagulation. This allows bleeding complications to be reduced and filter life time to be prolonged. However, citrate enters the systemic circulation and is metabolized in the liver to bicarbonate, causing metabolic alkalosis in some patients. In this case report, we discuss therapeutic interventions to control the acid-base status and to restore normal pH during continuous citrate hemodialysis.
ISSN:0391-3988
1724-6040
DOI:10.1177/039139880803100414