Acute Kidney Failure

Research on coagulation discussed by S. Morgera and co-researchers

Acute Kidney Failure Library Library Home This article was published in Biotech Business Week, which you can subscribe to online.

"Prospective observational study. University hospital. One hundred sixty-two patients with acute renal failure requiring renal replacement therapy were enrolled in the study. A continuous venovenous hemodialysis-based citrate anticoagulation protocol using a 4% trisodium solution, a specially designed dialysate fluid, and a continuous calcium infusion were used. The study period was 6 days. Hemofilters were changed routinely after 72 hours of treatment. The patients were grouped according to body weight, with patients below 60 kg body weight in group 1, patients with at least 60 kg and up to 90 kg body weight in group 2, and patients with a body weight of above 90 kg in group 3. Dialysate flow was adapted according to body size and matched approximately 2 L/hr for a patient with average body size. Blood flow, citrate flow, and calcium flow were adjusted according to the dialysate flow used. Median filter run time was 61.5 hours (interquartile range: 34.5-81.1 hours). Only 5% of all hemofilters had to be changed because of clotting. The prescribed treatment dose was achieved in all patients. Acid-base and electrolyte control were excellent in all groups. In the rare cases of metabolic disarrangement during citrate anticoagulation, acid-base values were rapidly corrected by modifying either the dialysate flow or alternatively the blood flow rate. Eight patients (5%) developed signs of citrate accumulation indicated by an increase of the total calcium >3 mmol/L or a need for high calcium substitution. We provide a safe and an easy-to-handle citrate anticoagulation protocol that allows an excellent acid-base and electrolyte control in critically ill patients with acute renal failure," wrote S. Morgera and colleagues.

The researchers concluded: "The protocol can be adapted to patients' need, allowing a wide spectrum of treatment doses. (Crit Care Med 2009; 37:2018-2024)."

Morgera and colleagues published their study in Critical Care Medicine (A safe citrate anticoagulation protocol with variable treatment efficacy and excellent control of the acid-base status. Critical Care Medicine, 2009;37(6):2018-2024).

For additional information, contact S. Morgera, University of Hospital Charite, Dept. of Nephrology, Campus Mitte, Berlin, Germany.

Publisher contact information for the journal Critical Care Medicine is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Germany, Berlin, Coagulation, Acute Kidney Failure, Acute Renal Failure, Clinical Trial Research, Critical Care, Endocrinology, Hematology, Hemodialysis, Heparin, Hypercalcemia, Kidney, Nephrology, Renal Dialysis, Renal Failure, Therapy, Treatment.

This article was prepared by Biotech Business Week editors from staff and other reports. Copyright 2009, Biotech Business Week via NewsRx.com.