title: Stability of continuous renal replacement therapy solutions after phosphate addition: an experimental study.
abstract: The incidence of hypophosphatemia is high in critically ill children on continuous renal replacement therapy (CRRT) and the addition of phosphate supplements to the replacement and dialysis fluids reduces the frequency of hypophosphatemia. The objective of this study was to determine the in vitro stability of the CRRT solutions after phosphate addition. Three different concentrations of phosphate, 2.5, 4.6 and 7.7 mg/dL, in the replacement and dialysis fluids were analyzed. The pH, glucose, total calcium, phosphate, and magnesium were determined before adding the phosphate and at 2, 24, and 48 h after its addition. The bags were macroscopically observed for possible precipitation. After addition of the phosphate, its concentration remained stable and there were no significant changes in the concentrations of the other components. There were no visible signs of precipitation up to 48 h. The addition of phosphate to the CRRT fluids at concentrations of up to 7.7 mg/dL does not cause problems with precipitation or instability of the mixture.
authors.affiliation: Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Pediatric Laboratory Department, Madrid, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Santiago
authors.forename: Jesús
authors.initials: J
authors.lastname: López-Herce
authors.forename: Rafael
authors.initials: R
authors.lastname: Muñoz
authors.forename: Jimena
authors.initials: J
authors.lastname: del Castillo
authors.forename: Javier
authors.initials: J
authors.lastname: Urbano
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Solana
authors.forename: Marta
authors.initials: M
authors.lastname: Botrán
mesh_terms: D002118:Calcium / Q000032:analysis; D011232:Chemical Precipitation; D015314:Dialysis Solutions / Q000737:chemistry* / Q000494:pharmacology; D008274:Magnesium / Q000032:analysis; D010710:Phosphates / Q000494:pharmacology*; D010758:Phosphorus / Q000032:analysis; D017582:Renal Replacement Therapy
chemical_list: D015314:Dialysis Solutions; D010710:Phosphates; D010758:Phosphorus; D008274:Magnesium; D002118:Calcium