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Citrate plasma levels assessment in patients with acute kidney injury undergoing continuous venovenous hemodiafiltration and regional citrate anticoagulation: a comparison between subjects with and without liver dysfunction


Between 5 to 10% of patients admitted to intensive care units require dialysis. Continuous renal replacement therapies (CRRT) are often used in this scenario. One of the most drawbacks of CRRT is ongoing anticoagulation. Regional citrate anticoagulation has been shown to be an effective and safe alternative, especially in bleeding risk situations. However, impaired hepatic citrate metabolism leads to citrate accumulation and toxicity. Thus, we intend to evaluate citrate plasma levels in patients with acute kidney injury undergoing continuous venovenous hemodiafiltration and regional citrate anticoagulation in two groups: individuals with (N = 40) and without (N = 60) liver failure. We will compare the demographics and laboratory data, parameters of dialysis adequacy, circuit lifetime, complications, and outcomes between these two groups. We will also correlate citrate levels with the total calcium/ionized calcium ratio, another marker of citrate intoxication. The prospective observational study will be conducted at Albert Einstein Hospital (São Paulo) in association with the Nephrology Division of Federal University of Sao Paulo. (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CLAIZONI DOS SANTOS, THAIS OLIVEIRA; DE SOUZA OLIVEIRA, MARISA APARECIDA; MARTINS MONTE, JULIO CESAR; BATISTA, MARCELO COSTA; PEREIRA JUNIOR, VIRGILIO GONCALVES; CARDOSO DOS SANTOS, BENTO FORTUNATO; PAVAO SANTOS, OSCAR FERNANDO; DURAO JUNIOR, MARCELINO DE SOUZA. Outcomes from a cohort of patients with acute kidney injury subjected to continuous venovenous hemodiafiltration: The role of negative fluid balance. PLoS One, v. 12, n. 4, . (12/19020-9)

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