Table 1 Studies describing the effects on calcium balance and iPTH in RCAÂ CRRT
Author | Van der Voort (25) | Brain (26) | Zheng (27) | Boer (28) | Raimundo (32) |
|---|---|---|---|---|---|
Modality | CVVH | CVVHDF | CVVH | CVVH | CVVHD |
Follow-up (hours) | 48 | 24 | 24 | 24 | 48 |
Numbers included | 9 patients in nadroparin vs 11 in citrate | 26 heparin, 22 citrate circuits in 13 patients | 20 patients in discovery cohort, 97 in validation cohort | 17 high-dose, 18 low-dose citrate | 30 patients |
Comparison | Nadroparin vs citrate | Citrate vs heparin | Two-phase citrate model | High-dose vs low-dose citrate | Citrate only |
Citrate dose (mmol/L) | 2.92 | 2.42 | 4.0 | 4.88 vs 3.08 | 4.0 |
Systemic iCa (mmol/L) | 0.8–1.0 | 0.8–1.1 | 1.0–1.2 |  > 1.0 | 1.12–1.2 |
Ca balance | Negative compared to nadroparin | − 4.01 mmol/h vs + 0.24/h | − 6.1 mmol/h | − 0.41 vs -0.05 mmol/h | – |
Ca balance in citrate group including extra Ca | – | − 1.12 mmol/h |  > 0 |  + 0.69 vs + 0.19 mmol/h | – |
iPTH (pg/ml) | Â | Â | Â | Â | Â |
Baseline | 28 | – | – | 222 | 66.5 |
24 h | 42.3 | – | – | 162 | 88.3 |
48 h | 30.0 | – | – | – | 85 |
Remarks | Calcium balance negative both with/without enteral feeding; non- randomized study | No enteral feeding Ca intake or loss via residual diuresis calculated | Study defining two-phase calcium compensation model when initiating RCA, only circuit and parenteral intake | Initial Ca balance including Ca compensation algorithm on 100%, Physician ordered calcium added | Designed to study effect on iPTH of keeping systemic iCa within physiological range during RCA CVVHD |