Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Acute Kidney Injury V: Interprofessional Care01:20

Acute 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...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Multi-Country Study of Stable Isotopes and Mineral Elements in European Pork.

Foods (Basel, Switzerland)·2026
Same author

Competing gene regulatory networks drive naive and memory B cell differentiation.

Molecular systems biology·2026
Same author

Patient doses in image-guided radiotherapy: status in Europe for cone-beam CT imaging in the pelvic region.

Radiology and oncology·2026
Same author

Social impact bonds: opportunities for funding health promotion and disease prevention.

BMC public health·2026
Same author

Smartwatch data from non-competitive athletes during the GiroE-2024 e-bike multi-stage race.

Data in brief·2026
Same author

Results of a Swiss community-based pilot study on low-dose ct lung cancer screening.

BMC pulmonary medicine·2026

Related Experiment Video

Updated: Jun 7, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Citrate anticoagulation using ACD solution A during long-term haemodialysis.

Stephen Wright1, Uli Steinwandel, Paolo Ferrari

  • 1Department of Nephrology, Fremantle Hospital, Perth, Western Australia, Australia.

Nephrology (Carlton, Vic.)
|November 9, 2010
PubMed
Summary

This study shows that using acid citrate dextrose solution A (ACDA) for regional citrate anticoagulation during haemodialysis is safe and effective. Adjusting ACDA infusion rates and monitoring ionized calcium levels are key to successful treatment in patients unable to use heparin.

Related Experiment Videos

Last Updated: Jun 7, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Biochemistry

Background:

  • Regional citrate anticoagulation (RCA) is an alternative to heparin for haemodialysis, especially in patients with bleeding risks.
  • Standard RCA protocols often use trisodium citrate, which has limited availability in Australia.
  • Acid citrate dextrose solution A (ACDA) is approved in Australia for apheresis and was adapted for RCA in haemodialysis.

Purpose of the Study:

  • To assess the safety and efficacy of a novel RCA protocol using ACDA for routine haemodialysis.
  • To establish an effective citrate anticoagulation strategy for patients with contraindications to heparin.

Main Methods:

  • A prospective study involving 14 patients and 150 haemodialysis treatments using calcium-free dialysate and ACDA.
  • An algorithm guided adjustments in ACDA infusion and intravenous calcium substitution to maintain post-filter ionized calcium between 0.2-0.3 mmol/L.
  • Point-of-care monitoring of ionized calcium at multiple time points during the 4-hour dialysis sessions.

Main Results:

  • Initial ACDA infusion rates (300 mL/h) led to dialyzer clotting in 6% of treatments.
  • Increasing the ACDA infusion rate to 350 mL/h resulted in successful completion of all subsequent 98 treatments.
  • Stable ionized calcium levels were maintained throughout, with normal post-dialysis serum sodium and bicarbonate.

Conclusions:

  • Routine haemodialysis with RCA using ACDA is safe and efficient in a long-term dialysis setting.
  • Point-of-care monitoring of ionized calcium is crucial for the successful and safe implementation of citrate anticoagulation.
  • This protocol provides a viable alternative for patients who cannot receive heparin-based anticoagulation.