1. Ionized Magnesium and Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy.
- Author
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Zakharchenko M, Leden P, Rulíšek J, Los F, Brodska H, and Balik M
- Subjects
- Acute Kidney Injury blood, Acute Kidney Injury pathology, Aged, Anticoagulants administration & dosage, Cations, Divalent, Citrates administration & dosage, Critical Illness, Female, Fluid Therapy methods, Hemofiltration, Humans, Intensive Care Units, Magnesium Deficiency blood, Magnesium Deficiency etiology, Magnesium Deficiency pathology, Male, Middle Aged, Prospective Studies, Respiration, Artificial, Acute Kidney Injury therapy, Anticoagulants adverse effects, Calcium blood, Citrates adverse effects, Fluid Therapy adverse effects, Hemodiafiltration, Magnesium blood
- Abstract
Background: The regional citrate anticoagulation (RCA) induces changes in total (Catot) and ionized (Ca2+) calcium. As of now, we do not have much information about parallel changes of total (Mgtot) and ionized (Mg2+) magnesium., Methods: The authors compared changes of Mg2+ and Mgtot with changes of Ca2+ and Catot in 32 critically ill patients on 4% trisodium citrate (4% TSC) with calcium-free fluids., Results: The median continuous venovenous hemodiafiltration balance of Mgtot was -0.91 (-1.18 to -0.53) mmol/h compared to the median balance of Catot 0.86 (0.08-1.55) mmol/h. Postfilter Mg2+ decreased by 68.3% (70.8-65.6) in parallel (r = 0.41, p = 0.03) to decrease of postfilter Ca2+ (by 70.2% (73.0-66.1)) and was significantly related to the postfilter Ca2+ (r = 0.50, p < 0.001). The decrease of prefilter to postfilter Ca2+ correlated to a dosage of 4% TSC per blood flow (r = 0.37, p = 0.04)., Conclusions: The loss of Mgtot during RCA is not covered by magnesium concentration in ordinary dialysis/substitution fluid and may lead to the depletion of total body magnesium. The postfilter Mg2+ is significantly related to the postfilter Ca2+. Video Journal Club "Cappuccino with Claudio Ronco" at http://www.karger.com/?doi = 440972., (© 2015 S. Karger AG, Basel.)
- Published
- 2016
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