The International journal of artificial organs
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Poor sleep and sleep-related breathing disorders are common in patients with end-stage renal disease (ESRD) but are often unrecognized and undertreated. Sleep disorders are known negative prognostic factors for morbidity and mortality. ⋯ Several uremic and nonuremic factors are thought to participate in the pathogenesis of sleep disorders in patients with ESRD. The therapy of sleeping disorders includes nonpharmacological and pharmacological measures that can improve the functionality and quality of life in patients with ESRD.
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Hemofiltration protocols using a citrate-buffered replacement solution offer the advantage of regional anticoagulation and a buffer effect. The role played by such fluids in clinical practice is not yet well established. The risk of electrolytic disorders, acid-base imbalance, or citrate accumulation should be clarified. We report on a renal therapy protocol based on a citrate isonatremic replacement solution. ⋯ Renal replacement therapy based on citrate-buffered fluid may be useful in clinical practice. This methodology presented an adequate metabolic control and allowed regional anticoagulation. A sufficient calcium supply was mandatory to avoid hypocalcemia. The small strong ion gap suggested a modest citrate accumulation.