Avtor/Urednik		Gubenšek, Jakob
Naslov		Področna antikoagulacija s citratom pri hemodializnih postopkih
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2006
Obseg		str. 71
Jezik		slo
Abstrakt		Background During the hemodialysis procedure, the prevention of blood clotting is necessary, for which heparin or low molecular weight heparins are usually used. When patients are bleeding, are at risk of bleeding, or have other contraindications for heparin, regional citrate anticoagulation is one of the main anticoagulation strategies. The aim of our study was to test an improved protocol for regional citrate anticoagulation during single-needle dialysis and a new protocol for regional citrate anticoagulation during double-needle hemodiafiltration and to confirm the hypothesis that anticoagulation by the protocols tested has good antithrombotic effects, a low rate of metabolic complications, and is tolerated well by patients. The aim of the third study was to test sequential anticoagulation (3.5 hours of citrate anticoagulation and half an hour of anticoagulant-free dialysis) during double-needle dialysis and to confirm, in a randomised prospective study, the following hypotheses: (1) that the antithrombotic effect during entire treatment is not significantly worse, and (2) that the serum citrate levels after dialysis are significantly lower with sequential anticoagulation as compared to standard citrate anticoagulation. Patients and methods All patients were adults with end-stage renal disease in the chronic hemodialysis program. In the first study, 32 dialyses were performed on 15 patients who needed citrate anticoagulation due to bleeding or an increased risk of bleeding and needed a singleneedle dialysis because of vascular access type. Citrate anticoagulation was performed using infusions of 4% sodium citrate and 1 mol/l calcium chloride; a calcium-free dialysate with a lowered sodium concentration of 138 mmol/l and 28 mmol/l bicarbonate was used. Ionized calcium, sodium, pH, bicarbonate and signs of hypocalcemia were monitored during the treatments. (Abstract truncated at 2000 characters)
Deskriptorji		KIDNEY FAILURE, CHRONIC HEMODIALYSIS ANTICOAGULANTS HEMODIAFILTRATION CITRATES