Citrate Type Haemodialysis Solution

  • Citrate system suppresses dialysis-associated degranulation of polymorphonuclear cells and platelets, and led to reduced plasma level of oxidized low-density lipoprotein.
  • Significantly lower plasma levels of pro-inflammatory interleukin-1 beta early during CITRATE dialysis are found.
  • Citrate-containing dialysis fluid, significantly reduces levels of C-reactive protein and interleukin-6, with concomitant positive effects on nutritional parameters, when regular dialysis fluid was replaced with acetate-free citrate-containing dialysis fluid was found.
  • Furthermore, citrate decreases both apoptosis and necrosis and reduced markers of inflammation . These results indicate that citrate in dialysis may be beneficial when attempting to reduce the high cardiovascular morbidity in HD patients.

The composition of the citric acid dialysis solution is as follows:

PART I : The acid concentrate (in liquid form) is composed of the following components in each 1000ml:

  • NaCl : 165.00g
  • KCl: 6.00g
  • CaCl2: 8.10g
  • MgCl2: 3.70g
  • Citric Acid: 5.70g
  • H20: Q.S

PART II: The bicarb concentrate part containing

  • NaHCO3: 660.0g
  • NaCl: 240.0g

Procedure for use:

  • Part I supplied in liquid form in white jerry cans of 10 lts.
  • Part II supplied in polythene bags of 900 g each (2 packs are supplied with each can)
  • The total contents of part II are dissolved in purified water up to 10lts
  • The operator manual of the individual dialysis machine should be followed to obtain the final dialysate options based on a compatible concentrate-pair and standard proportioning ratio to give a final solution by mixing 1:1.83:34 parts of part I:part II: purified water.