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Changes in calcium distribution during therapeutic plasmapheresis.
Archives of Pathology & Laboratory Medicine
|November 1, 1984
Summary
Citrate during plasmapheresis causes shifts in serum calcium, decreasing ionized and protein-bound calcium while increasing anion-bound calcium. This suggests protein-bound calcium is labile and helps maintain stable ionized calcium levels.
Area of Science:
- Biochemistry
- Clinical Chemistry
- Nephrology
Background:
- Plasmapheresis is a medical procedure to remove plasma from the blood.
- Citrate is commonly used as an anticoagulant during blood collection and plasmapheresis.
- Calcium (Ca) exists in various forms in serum, including ionized, protein-bound, and ultrafilterable fractions.
Purpose of the Study:
- To confirm and extend findings on serum calcium shifts during plasmapheresis in patients.
- To investigate the impact of citrate anticoagulant on different calcium fractions.
Main Methods:
- Measurements of total, ionized, and ultrafilterable calcium concentrations were performed.
- Therapeutic plasmapheresis using anticoagulant citrate dextrose solution was conducted on 11 patients.
Main Results:
- A net shift of serum calcium was observed from ionized and protein-bound fractions to the anion-bound fraction.
- Mean concentrations of total, ionized, and protein-bound calcium decreased.
- Ultrafilterable and anion-bound calcium fractions showed an increase.
Conclusions:
- Protein-bound calcium appears to be a labile pool that contributes to maintaining stable ionized calcium levels.
- Citrate infusion during plasmapheresis induces a shift in calcium fractions, favoring the anion-bound pool over ionized and protein-bound pools.