Aims: To evaluate the efficacy and safety of a commercially available phosphate-containing solution for continuous renal replacement therapy (CRRT) in preventing CRRT-related hypophosphatemia. Methods: In heart surgery patients undergoing continuous venovenous haemodiafiltration (CVVHDF) with regional citrate anticoagulation (RCA), we combined an 18 mmol/l citrate solution with a phosphate-containing (1.2 mmol/l) dialysate/replacement fluid evaluating the incidence of hypophosphatemia and the need for parenteral phosphorus supplementation. Results: In 75 pa- tients on RCA-CVVHDF, the mean filter life was 53.9 ± 33.6 h. Regardless of baseline levels, phosphoremia was progressively corrected and maintained in a narrow normality range throughout RCA-CRRT days (after 72 h: 1.14 ± 0.25 mmol/l). Considering the whole CRRT period, 45 out of 975 (4.6%) use- rum phosphorus determinations met the criteria for mild (<0.81 mmol/l) or moderate (<0.61 mmol/l) hypophosphatemia; severe hypophosphatemia (<0.32 mmol/l) never occurred. After 72 h 88% of the patients were normophosphatemic, 9% hyperphosphatemic and 3% hypophosphatemic. Conclusions: RCA-CVVHDF with a phosphate-containing solution enabled the maintenance of phosphorus levels within normophosphatemic range in most of the patients, minimizing the occurrence of CRRT-related hypophosphatemia.

Preventing continuous renal replacement therapy-induced hypophosphatemia. an extended clinical experience with a phosphate-containing solution in the setting of regional citrate anticoagulation / Pistolesi, Valentina; Zeppilli, Laura; Polistena, Francesca; Sacco, Maria Itala; Pierucci, Alessandro; Tritapepe, Luigi; Regolisti, Giuseppe; Fiaccadori, Enrico; Morabito, Santo. - In: BLOOD PURIFICATION. - ISSN 0253-5068. - STAMPA. - 44:1(2017), pp. 8-15. [10.1159/000453443]

Preventing continuous renal replacement therapy-induced hypophosphatemia. an extended clinical experience with a phosphate-containing solution in the setting of regional citrate anticoagulation

Pistolesi, Valentina
;
Zeppilli, Laura;Polistena, Francesca;Sacco, Maria Itala;Pierucci, Alessandro;Tritapepe, Luigi;Morabito, Santo
2017

Abstract

Aims: To evaluate the efficacy and safety of a commercially available phosphate-containing solution for continuous renal replacement therapy (CRRT) in preventing CRRT-related hypophosphatemia. Methods: In heart surgery patients undergoing continuous venovenous haemodiafiltration (CVVHDF) with regional citrate anticoagulation (RCA), we combined an 18 mmol/l citrate solution with a phosphate-containing (1.2 mmol/l) dialysate/replacement fluid evaluating the incidence of hypophosphatemia and the need for parenteral phosphorus supplementation. Results: In 75 pa- tients on RCA-CVVHDF, the mean filter life was 53.9 ± 33.6 h. Regardless of baseline levels, phosphoremia was progressively corrected and maintained in a narrow normality range throughout RCA-CRRT days (after 72 h: 1.14 ± 0.25 mmol/l). Considering the whole CRRT period, 45 out of 975 (4.6%) use- rum phosphorus determinations met the criteria for mild (<0.81 mmol/l) or moderate (<0.61 mmol/l) hypophosphatemia; severe hypophosphatemia (<0.32 mmol/l) never occurred. After 72 h 88% of the patients were normophosphatemic, 9% hyperphosphatemic and 3% hypophosphatemic. Conclusions: RCA-CVVHDF with a phosphate-containing solution enabled the maintenance of phosphorus levels within normophosphatemic range in most of the patients, minimizing the occurrence of CRRT-related hypophosphatemia.
2017
acute kidney injury; citrate; continuous renal replacement therapy; continuous veno-venous haemodiafiltration; hypophosphatemia; regional citrate anticoagulation; aged; blood coagulation; cardiac surgical procedures; citrates; dialysis solutions; female; humans; hypophosphatemia; male; middle aged; phosphates; renal replacement therapy; retrospective studies; treatment outcome; hematology; nephrology
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Preventing continuous renal replacement therapy-induced hypophosphatemia. an extended clinical experience with a phosphate-containing solution in the setting of regional citrate anticoagulation / Pistolesi, Valentina; Zeppilli, Laura; Polistena, Francesca; Sacco, Maria Itala; Pierucci, Alessandro; Tritapepe, Luigi; Regolisti, Giuseppe; Fiaccadori, Enrico; Morabito, Santo. - In: BLOOD PURIFICATION. - ISSN 0253-5068. - STAMPA. - 44:1(2017), pp. 8-15. [10.1159/000453443]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1089274
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