File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)

Article: A prospective study on serum citrate levels and clinical correlations in patients receiving regional citrate anticoagulation

TitleA prospective study on serum citrate levels and clinical correlations in patients receiving regional citrate anticoagulation
Authors
Issue Date15-Oct-2022
PublisherOxford University Press
Citation
Clinical Kidney Journal, 2022, v. 16, n. 2, p. 285-292 How to Cite?
Abstract

Background

Current ways to diagnose citrate accumulation (CA) in patients receiving regional citrate anticoagulation (RCA) continuous renal replacement therapy (CRRT) are confounded by various clinical factors. Serum citrate measurement emerges as a more direct way to diagnose CA, but its clinical utility and optimal cut-off values remain undefined. This study examined serum citrate kinetics and its diagnostic performance for CA in patients receiving RCA CRRT.

Methods

A multicentre prospective study was carried out in two tertiary referral centre intensive care units in Hong Kong with serum citrate levels measured at baseline and 2, 6, 12, 24, 36, 48 and 72 h after initiation of RCA CRRT and their relationships with the development of CA.

Results

Among the 133 patients analysed, 18 patients (13.5%) developed CA. The serum citrate levels at baseline and 2, 6 and 12 h after initiation of RCA CRRT in patients who had CA were significantly higher than the non-CA group (P < .001 for all). The CA group also had higher serum citrate levels than the non-CA group {median 0.93 mmol/L [interquartile range (IQR) 0.81–1.16) versus 0.37 mmol/L (IQR 0.26–0.57), P < .001}. Using a cut-off of 0.85 mmol/L, the serum citrate level had a sensitivity of 0.77 and a specificity 0.96 for the diagnosis of CA [area under the receiver operating characteristics curve (AUROC) 0.90, P < .001]. The 2-h and 6-h serum citrate levels had good discriminatory abilities for predicting subsequent development of CA (AUROC 0.86 and 0.83 for 2-h and 6-h citrate levels using cut-off values of 0.34 and 0.63 mmol/L, respectively; P < .001).

Conclusion

Serum citrate levels were significantly higher in patients with CA compared with patients without CA. Serum citrate levels showed good performance in diagnosing and predicting the development of CA.


Persistent Identifierhttp://hdl.handle.net/10722/331023
ISSN
2023 Impact Factor: 3.9
2023 SCImago Journal Rankings: 1.191

 

DC FieldValueLanguage
dc.contributor.authorTo, HHM-
dc.contributor.authorKwan, AMC-
dc.contributor.authorLeung, NYY-
dc.contributor.authorChan, WM-
dc.contributor.authorNgai, CW-
dc.contributor.authorWong, ASK-
dc.contributor.authorTsai, PNW-
dc.contributor.authorMa, TSK-
dc.contributor.authorYam, I-
dc.contributor.authorNg, PY-
dc.contributor.authorYap, DYH-
dc.date.accessioned2023-09-21T06:52:05Z-
dc.date.available2023-09-21T06:52:05Z-
dc.date.issued2022-10-15-
dc.identifier.citationClinical Kidney Journal, 2022, v. 16, n. 2, p. 285-292-
dc.identifier.issn2048-8505-
dc.identifier.urihttp://hdl.handle.net/10722/331023-
dc.description.abstract<p>Background</p><p>Current ways to diagnose citrate accumulation (CA) in patients receiving regional citrate anticoagulation (RCA) continuous renal replacement therapy (CRRT) are confounded by various clinical factors. Serum citrate measurement emerges as a more direct way to diagnose CA, but its clinical utility and optimal cut-off values remain undefined. This study examined serum citrate kinetics and its diagnostic performance for CA in patients receiving RCA CRRT.</p><p>Methods</p><p>A multicentre prospective study was carried out in two tertiary referral centre intensive care units in Hong Kong with serum citrate levels measured at baseline and 2, 6, 12, 24, 36, 48 and 72 h after initiation of RCA CRRT and their relationships with the development of CA.</p><p>Results</p><p>Among the 133 patients analysed, 18 patients (13.5%) developed CA. The serum citrate levels at baseline and 2, 6 and 12 h after initiation of RCA CRRT in patients who had CA were significantly higher than the non-CA group (<em>P</em> < .001 for all). The CA group also had higher serum citrate levels than the non-CA group {median 0.93 mmol/L [interquartile range (IQR) 0.81–1.16) versus 0.37 mmol/L (IQR 0.26–0.57), <em>P</em> < .001}. Using a cut-off of 0.85 mmol/L, the serum citrate level had a sensitivity of 0.77 and a specificity 0.96 for the diagnosis of CA [area under the receiver operating characteristics curve (AUROC) 0.90, <em>P</em> < .001]. The 2-h and 6-h serum citrate levels had good discriminatory abilities for predicting subsequent development of CA (AUROC 0.86 and 0.83 for 2-h and 6-h citrate levels using cut-off values of 0.34 and 0.63 mmol/L, respectively; <em>P</em> < .001).</p><p>Conclusion</p><p>Serum citrate levels were significantly higher in patients with CA compared with patients without CA. Serum citrate levels showed good performance in diagnosing and predicting the development of CA.</p>-
dc.languageeng-
dc.publisherOxford University Press-
dc.relation.ispartofClinical Kidney Journal-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleA prospective study on serum citrate levels and clinical correlations in patients receiving regional citrate anticoagulation-
dc.typeArticle-
dc.identifier.doi10.1093/ckj/sfac223-
dc.identifier.volume16-
dc.identifier.issue2-
dc.identifier.spage285-
dc.identifier.epage292-
dc.identifier.eissn2048-8513-
dc.identifier.issnl2048-8505-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats