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Table 3 Patients with and without citrate accumulation, hepatic function at start of continuous renal replacement therapy

From: Long-term continuous renal replacement therapy and anticoagulation with citrate in critically ill patients with severe liver dysfunction

Parameter

Accumulation of citrate; tCa/iCa ratio > 2.4

No accumulation of citrate; tCa/iCa ratio ≤ 2.4

p Value

No. of patients

16

53

 

Age, years

57.4 ± 14.0

59.6 ± 11.9

n.s.

MELD score

33.1 ± 4.2

28.8 ± 5.0

0.001

Prothrombin time, Quick value (%)

41.2 ± 23.6

57.1 ± 19.3

0.004

Bilirubin, mg/dl

8.3 ± 11.1

8.7 ± 11.9

n.s.

ICG-PDR

7.4 ± 5.5

10.7 ± 6.4

n.s.

Duration of CRRT, days

11.6 ± 8.6

22.1 ± 26.3

0.014

Mean flow of dialysate, ml/h

2234.1 ± 501.9

2173.7 ± 437.8

n.s.

Effective dialysis dose, ml/kg/h

28.8 ± 8.5

28.9 ± 8.6

n.s.

Mean dose of citrate, mmol/L blood

4.2 ± 2.6

4.0 ± 2.6

0.025

Mean Ca2+ substitution, mmol/L dialysate

1.66 ± 0,15

1.55 ± 0,30

0.038

Total Ca2+, mmol/L

2.67 ± 0.17

2.47 ± 0.15

0.000

iCa post–filter, mmol/L

0.32 ± 0.02

0.29 ± 0.05

0.001

iCa in patient, mmol/L

1.07 ± 0.06

1.14 ± 0.09

0.000

Death, n (%)

11 (68.8%

29 (54.7%

n.s.

Vasopressor support, % of CRRT duration

65.8 ± 39.7

55.2 ± 32.8

n.s.

Maximal SAPS II score

56.2 ± 14.4

56.2 ± 13.5

n.s.

Stay in ICU, days

14.9 ± 11.6

35.1 ± 34.1

0.001

  1. Abbreviations: CRRT Continuous renal replacement therapy, iCa Ionised serum calcium, ICG-PDR Indocyanine green plasma disappearance rate, ICU Intensive care unit, MELD Model for End-stage Liver Disease, n.s. Not significant, SAPS II Simplified Acute Physiology Score II, tCa/iCa Total serum calcium/ionised serum calcium
  2. Results are shown as mean ± SD