title: Ionized Magnesium and Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy.
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.
authors.affiliation: Department of Anesthesiology and Intensive Care, Charles University and General University Hospital in Prague, Prague, Czech Republic.
authors.forename: Mychajlo
authors.initials: M
authors.lastname: Zakharchenko
authors.forename: Pavel
authors.initials: P
authors.lastname: Leden
authors.forename: Jan
authors.initials: J
authors.lastname: Rulíšek
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Los
authors.forename: Helena
authors.initials: H
authors.lastname: Brodska
authors.forename: Martin
authors.initials: M
authors.lastname: Balik
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000473:pathology / Q000628:therapy*; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D002118:Calcium / Q000097:blood*; D002413:Cations, Divalent; D002951:Citrates / Q000008:administration & dosage / Q000009:adverse effects*; D016638:Critical Illness; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects* / Q000379:methods; D017583:Hemodiafiltration; D006440:Hemofiltration; D006801:Humans; D007362:Intensive Care Units; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000097:blood / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial
chemical_list: D000925:Anticoagulants; D002413:Cations, Divalent; D002951:Citrates; C514290:trisodium citrate; D008274:Magnesium; D002118:Calcium