title: Citrate versus acetate-based dialysate in on-line haemodiafiltration. A prospective cross-over study.
abstract: OBJECTIVE
  A bicarbonate dialysate acidified with citrate (CD) has been reported to have local anticoagulant effect and improves biocompatibility. This study examines the effect of CD on dialysis efficiency, coagulation, acid-base status, electrolytes, and inflammation in patients in on-line hemodiafiltration (OL-HDF).
  
  
  METHODS
  35 patients in OL-HDF were enrolled in a prospective, cross-over study for a 24-week period and two phases alternating CD and acetate dialysate fluid (AD). Parameters on study were predialysis levels of bicarbonate and ionic calcium, reactive C Protein (CRP), and beta-2 microglobulin (B2MG) and postdialysis levels of activated tromboplastine time, bicarbonate, and ionized calcium.
  
  
  RESULTS
  No significant differences in coagulation parameters, pH, and predialysis bicarbonate were found. The postdialysis bicarbonate and postdialysis calcium were lower with CD. Dialysis efficiency was greater with CD. Regarding inflammatory parameters, both CRP and B2MG were lower using CD.
  
  
  CONCLUSIONS
  The use of CD is safe and effective in OL-HDF, and it improves dialysis efficacy, postdialysis alkalosis, and inflammation.
authors: Manuel
authors: M
authors: Molina Nuñez
authors: Rosa
authors: R
authors: de Alarcón
authors: Susana
authors: S
authors: Roca
authors: Gracia
authors: G
authors: Álvarez
authors: María Soledad
authors: MS
authors: Ros
authors: Cristina
authors: C
authors: Jimeno
authors: Laura
authors: L
authors: Bucalo
authors: Isabel
authors: I
authors: Villegas
authors: María Ángeles
authors: MÁ
authors: García
mesh_terms: D000085:Acetates / Q000627:therapeutic use*; D000137:Acid-Base Imbalance / Q000097:blood / Q000473:pathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001639:Bicarbonates / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002118:Calcium / Q000378:metabolism; D002951:Citrates / Q000627:therapeutic use*; D018592:Cross-Over Studies; D015314:Dialysis Solutions / Q000737:chemistry / Q000627:therapeutic use*; D017583:Hemodiafiltration / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011446:Prospective Studies; D001613:beta 2-Microglobulin / Q000378:metabolism
chemical_list: D000085:Acetates; D001639:Bicarbonates; D002951:Citrates; D015314:Dialysis Solutions; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D002118:Calcium