Related Experiment Video
Updated: Jul 13, 2026
08:47
Microdialysis of Excitatory Amino Acids During EEG Recordings in Freely Moving Rats
Published on: November 8, 2018
Dialysate made from dry chemicals using citric acid increases dialysis dose
1Department of Medicine, Division of Nephrology, University of Washington, Seattle, WA, USA. sahmad@u.washington.edu
Summary
Citrate dialysate, a new option for hemodialysis patients, was well tolerated. This citric acid-based fluid improved dialysis dose delivery compared to standard acetic acid dialysate.
Area of Science:
- Nephrology
- Renal Replacement Therapy
Background:
- Hemodialysis utilizes dialysate to remove waste products and excess fluid from the blood.
- Traditional dialysate is often acidified with acetic acid, which can influence electrolyte balance.
Purpose of the Study:
- To evaluate the safety and efficacy of a new dry dialysate concentrate acidified with citric acid (citrate dialysate) in hemodialysis patients.
- To compare the effects of citrate dialysate versus standard acetic acid dialysate on blood chemistry and dialysis dose.
Main Methods:
- A prospective, randomized, crossover study compared citrate dialysate with regular dialysate in 74 hemodialysis sessions.
- A second 12-week study assessed the long-term effects of exclusive citrate dialysate use in 25 patients.
- Blood electrolyte levels, serum citrate and bicarbonate, and dialysis dose (urea reduction ratio and Kt/V) were measured.
Main Results:
- Citrate dialysate led to greater reductions in total/ionized calcium, magnesium, and chloride compared to acetic acid dialysate.
- While serum sodium and citrate increased with citrate dialysate, levels remained within or near normal ranges.
- Over 12 weeks, citrate dialysate use showed a declining trend in predialysis magnesium, potassium, and citrate, with improved predialysis bicarbonate levels.
- Patients on citrate dialysate experienced a significant increase in delivered dialysis dose (urea reduction ratio and Kt/V).
Conclusions:
- Citrate dialysate is well-tolerated and demonstrates similar intradialytic blood chemistry changes to regular dialysate.
- The use of citric acid instead of acetic acid in dialysate enhances the delivered dialysis dose.
- Citrate dialysate represents a viable alternative for hemodialysis, potentially improving treatment efficiency.
Related Concept Videos
01:19Ionic Strength: Effects on Chemical Equilibria
The addition of an inert ionic compound increases the solubility of a sparingly soluble salt. For example, adding potassium nitrate to a saturated solution of calcium sulfate significantly enhances the solubility of calcium sulfate. Le Châtelier's principle cannot predict this shift in the equilibrium. Instead, this could be explained in terms of changes in the effective concentration of the ions in solution in the presence of added inert salt.
In this solution, the primary cation—the calcium...
In this solution, the primary cation—the calcium...
01:15Dialysis
Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
01:27Dialysis
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
01:30Peritoneal Dialysis I: Introduction and Procedure
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
01:20Acute Kidney Injury V: Interprofessional Care
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...