• Peter H J van der Voort, Sonja R Postma, W Peter Kingma, E Christiaan Boerma, Loek J M de Heide, and Andries J Bakker.
• Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands. phjvdvoort@chello.nl
• Blood Purif. 2007 Jan 1; 25 (3): 267-73.

BackgroundTo study calcium homeostasis during citrate-based compared to nadroparin-based CVVH in critically-ill patients with acute renal failure.Methods11 patients were observed during citrate anticoagulation, 9 with nadroparin and 10 controls. Citrate was chosen for patients with active or at risk for bleeding.ResultsThe controls had, at 24 h, a median serum iCa of 1.1 mmol/l, the citrate group 0.87 mmol/l and the nadroparin group 1.1 mmol/l (citrate vs. control p = 0.001, citrate vs. nadroparin p = 0.002). At 48 h, iCa was not significantly different anymore. Ca balance was negative for the citrate group in contrast to the nadroparin group (p = 0.012). Median serum PTH was higher (30.0 pmol/l vs. 6.5 pmol/l, p = 0.003) in the citrate group.ConclusionWith a relative low target-serum-iCa (0.8-0.9 mmol/l) citrate CVVH-treated patients had a negative daily calcium balance and a temporarily lower iCa level resulting in an enhanced PTH response in comparison to nadroparin.Copyright 2007 S. Karger AG, Basel.

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