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Kidney Week

Abstract: TH-PO265

To Study the Clinical and Biochemical Outcomes of Citrate-Based Dialysate in Hemodialysis Compared with Bicarbonate-Based Dialysate in a Tertiary Care Hospital

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kurundwadkar, Mohit Mohan, Sri Balaji Action Medical Institute, New Delhi, Delhi, India
  • Aggarwal, Rajesh, Sri Balaji Action Medical Institute, New Delhi, Delhi, India
  • Bhalla, Blessy Sehgal, Sri Balaji Action Medical Institute, New Delhi, Delhi, India
  • Bohra, Vikas Kumar, Sri Balaji Action Medical Institute, New Delhi, Delhi, India
Background

The study to compare the effects of Citrate-based dialysate with Bicarbonate-based dialysate on systemic haemodynamics ,dialysis efficiency,serum calcium, phosphate and bicarbonate levels.

Methods

The study was conducted in 25 ESRD patients undergoing HD with bicarbonate dialysate initially for period of 3 months followed by citrate dialysate for 3 months.Parameters were recorded at start,3 months of HD with bicarbonate dialysate and HD with citrate dialysate at 6 months. Predialytic, intradialytic and postdialytic BP was recorded at each HD session. The mean of all BP readings was calculated for both groups.The clinical and lab parameters Kt/v, calcium, phosphate and bicarbonate levels were compared among both groups

Results

The mean Predialytic SBP in bicarbonate is 153.84 ± 16.80 mmhg, in Citrate dialysate is 140.24 ± 16.63 mmhg(p<0.001),mean Predialytic DBP in bicarbonate is 87.16 ± 10.75 mmhg, in citrate dialysate is 79.96± 8.63 mmhg (p<0.001).The Intradialytic SBP and DBP were lower in pts.undergoing citrate vs bicarbonate.The mean Intradialytic SBP in bicarbonate is 148.56 ± 15.50 mmhg vs 135.92 ± 15.29 in citrate(p=0.0053).The mean Intradialytic DBP in bicarbonate is 84.12 ± 12.02 mmhg vs 75.92 ± 8.94 mmhg in citrate(p=0.0086). The mean Postdialytic SBP in bicarbonate is 143.56 ± 17.50 mmhg vs 129.24 ± 15.46 in citrate(p=0.0035).The mean Postdialytic DBP in bicarbonate is 82.40 ± 10.07 mmhg vs74.20 ± 7.04 mmhg in citrate(p value=0.0016).The mean Kt/v in bicarbonate is 1.2 ± 0.06 vs 1.33± 0.06 in citrate (p value<0.001) .The mean calcium level in bicarbonate is 9.03 ± 1.03 mg/dl vs 8.51 ± 0.97 mg/dl in citrate(p=0.07),the phosphate in bicarbonate dialysate is 5.53 ± 1.04 vs 4.76 ± 1.72 in citrate (p value=0.06).The mean HCO3 level in bicarbonate dialysate is 16.08 ± 1.39 vs 17.75 ± 1.34 in citrate group(p value<0.001)

Conclusion

Citrate dialysate can be good alternative for the standard bicarbonate based dialysate as it provides significant advantages in improvement in Pre, Intra And Postdialytic BP, better dialysis efficiency, improved acid base balance and lower phosphate levels.