{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T02:16:18Z","timestamp":1770516978543,"version":"3.49.0"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The safety of continuous veno\u2010venous hemodialysis (CVVHD) with citrate\u2010calcium anticoagulation for acute kidney injury (AKI) with coincident hyponatremia remains unclear. We aimed to explore the feasibility of CVVHD with standard dialysate and citrate\u2010calcium anticoagulation in hyponatremic critically ill AKI patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010seven of the 493 critically ill AKI patients requiring CVVHD and admitted to our intensive care unit during a 10\u2010year period had hyponatremia (&lt;130\u00a0mmol\/L) and were included in this retrospective study. All patients received CVVHD with citrate\u2010calcium anticoagulation and standard commercial dialysate and plasma sodium concentrations were frequently controlled until death or CVVHD discontinuation. Clinical data, mortalities and cases of central pontine myelinolysis within one\u2010year follow\u2010up were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median plasma sodium concentration was 127 (IQR 124\u2010129)\u00a0mmol\/L at CVVHD initiation. CVVHD duration was median 3 (IQR 1.5\u20105.5)\u00a0days and the mean daily sodium load of the trisodium citrate solution during the first 3\u00a0days of CVVHD was 1754 (SD 730)\u00a0mmol. The plasma sodium concentration increased a median 8 (IQR 5\u201010)\u00a0mmol\/L during the first 24\u00a0hours of CVVHD and excessively high plasma sodium correction (&gt;8\u00a0mmol\/L\/24\u00a0h) was observed in 18 (48.6%) patients. However, increased mortality in association to rapid plasma sodium correction was not observed in this study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CVVHD using standard citrate\u2010calcium anticoagulation effectively increased plasma sodium concentration in this study. However, excessively high plasma sodium correction was observed in half of the patients and the sodium load provided by the standard citrate anticoagulation solutions was substantial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13798","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T03:33:13Z","timestamp":1613619193000},"page":"778-784","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Continuous hemodialysis with citrate anticoagulation and standard dialysate for managing acute kidney injury in patients with moderate to severe hyponatremia\u2014A retrospective study"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9453-5687","authenticated-orcid":false,"given":"Tapio","family":"Hellman","sequence":"first","affiliation":[{"name":"Kidney Center Turku University Hospital and University of Turku Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panu","family":"Uusalo","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Turku University Hospital and University of Turku Turku Finland"},{"name":"Perioperative Services, Intensive Care and Pain Medicine Turku University Hospital and University of Turku Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko J.","family":"J\u00e4rvisalo","sequence":"additional","affiliation":[{"name":"Kidney Center Turku University Hospital and University of Turku Turku Finland"},{"name":"Department of Anaesthesiology and Intensive Care Turku University Hospital and University of Turku Turku Finland"},{"name":"Perioperative Services, Intensive Care and Pain Medicine Turku University Hospital and University of Turku Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.12123"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1692-0"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V481522"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2013.07.006"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu040"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2020.05.007"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-015-0215-1"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1159\/000509024","article-title":"Feasibility of citrate dialysis in hyponatremia: a case series","volume":"50","author":"Redant S","year":"2021","journal-title":"Blood 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