| Author/Editor | Černe, Senka | |
| Title | Področno preprečevanje strjevanja krvi s citratom med hemodializo: primerjava dializne raztopine z in brez kalcija | |
| Type | monografija | |
| Place | Ljubljana | |
| Publisher | Univerza v Ljubljani, Medicinska fakulteta | |
| Publication year | 2007 | |
| Volume | str. 37 | |
| Language | slo | |
| Abstract | Effective anticoagulation with unfractionated heparin or low molecular heparin during hemodialysis procedure is important for efficient and successful dialysis. However, if heparin is contraindicated (risk of bleeding, HIT-heparin-induced thrombocytopenia), regional curate anticoagulation provides safe prevention of blood clotting in dialysis circuit without causing systemic anticoagulation. In a prospective randomized clinical study we have compared the efficacy and safety of two protocols for regional anticogulation with trisodium citrate using calcium free dialysate and dialysate with calcium 1,25 mmol/l. In our study we enrolled patients older than 18 years with end stage renal disease, in whom we have already performed regional citrate anticoagulation with 4% solution of trisodium citrate without any complications. 50 hemodialysis procedures were randomly assigned (25 to each group) to calcium-free dialysate or calcium containing dialysate (1,25 mmol/1) both with Mg 0,5 mmol/l, lowered concentrations of sodium (138 mmol/1) and bicarbonate (28 mmol/1). We performed regional anticoagulation with infusion of 15% trisodium citrate and 1M CaCl2. The efficiency of anticoagulation was assessed using hour-glass clotting time, measuring concentration of ionised calcium after citrate infusion in dialysis circuit, measuring the volume of clots in arterial or venous bubble trap and counting the number of clotted capillaries in dialyser. The scoring system for evaluation of anticoagulation in the dialyser and arterial and venous bubble trap was ranged from 1 (complete clotting) to 5 ( the best, no clotting). During the treatment we monitored the concentrations of ionized calcium, sodium, pH and bicarbonate. Using calcium free dialysate our results showed very good anticoagulation score for both bubble traps (arterial 4,7 +- 0,5 and venous 4,8 +- 0,6) and dialyzer (4,5 +- 0,6). (Abstract truncated at 2000 characters) | |
| Descriptors | HEMODIALYSIS CITRATES HEMODIALYSIS SOLUTIONS ANTICOAGULANTS CALCIUM SODIUM BICARBONATES HYDROGEN-ION CONCENTRATION RANDOMIZED CONTROLLED TRIALS |