Comparison of Efficacy of Dialysis (Kt/V) and Adverse Effect Profile of Citrate Versus Acetate Based Dialysate Solution
DOI:
https://doi.org/10.51253/pafmj.v76iSUPPL-3.13038Keywords:
Acetate Dialysate, Citrate dialysate, Dialysis efficacy, HypocalcemiaAbstract
Objective: To compare efficiency of dialysis (Kt/V) and incidence of Intra-Dialytic Hypotension (IDH) and muscle cramps with use of acetate versus citrate-based dialysate solution in patients on maintenance hemodialysis.
Study Design: Quasi-experimental study.
Place and Duration of study: Pak Emirates Military Hospital (PEMH), Rawalpindi, Pakistan, from Mar to Aug 2024.
Methodology: After gaining approval from Ethics Committee and obtaining written, informed consent of all participants, 120 patients were enrolled from Dialysis Unit, PEMH, Rawalpindi, Pakistan. In the first leg, six hemodialysis sessions were done using acetate-based dialysate solution (RenaCarb). Vitals and lab parameters including renal function tests (RFTs), electrolytes and Kt/V, were noted in each session along with reports of Intra Dialytic Hypotension (IDH) and muscle cramp episodes. After 2 weeks, patients were crossed over to the second leg and six sessions of dialysis were done using citrate-based dialysate solution (RenaCit). All data was collected and analyzed using Statistical Package for the Social Sciences (SPSS) Version 22.00.
Results: Mean Kt/V for Leg 1 was lesser than for Leg 2 (1.21 ± 0.08 vs 1.35 ± 0.09) with p<0.01, while IDH episodes were also higher in number in Leg 1 than in Leg 2 (34 vs 12) with p<0.01 but there were no statistically significant differences in incidence of post-dialysis cramps or bleeding between Leg 1 or 2.
Conclusion: Dialysis sessions with citrate-based dialysate had better dialysis efficacy and lesser number of IDH episodes than with acetate-based dialysate while incidence of muscle cramps was not statistically significant between ...
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