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Using citrate-containing dialysate, a reduction of the heparin dose by up to 55% was described in the literature (Kossmann et al., 2006, 2009). At the same time, the efficacy of dialysis was found to be increased. A local anticoagulation inside the dialyzer was supposed to be the reason, caused by a strong decrease of free calcium ions. A diminished thrombus formation inside the dialyzer should allow a higher mass transport across the membrane. The reduction of acetate concentration in the dialysate was found to increase the hemodynamic stability of hypertensive patients (Gabutti et al., 2009). So far, the question has not been investigated whether the reduction of acetate diminishes the inflammatory potential of acetate in such a way that the activation of thrombocytes and leucocytes as well as the release of cytokines will be reduced. Until now, a reduction of beta-2-microglobulin (beta-2-m) was observed, which could be attributed to an improved permeability of the membrane (Kossmann et al., 2009). The possible reduction of heparin by means of Citrasate® during chronic hemodialysis could lead to an economical benefit. The clinical benefit for patients would consist of the reduction of described side effects of acetate and heparin. Because of the small number of publications, it makes sense to verify the previous results and to check if the observed reduction of beta-2-m could be caused also by a reduction of oxidative potential in case of Citrasate® application.

intech ebooks

Reduction of Heparin and Oxidative Potential by Means of Citrasate® in High-Flux Dialysis (HFD) and Online Hemodiafiltration (olHDF) in Pre and Postdilution