The optimum concentration of dialysate Ca++ using citrate

We have confirmed that satisfactory anticoagulation can be accomplished by the application of citrate at concentrations of from 1.0 to 1.5mM in the hemodialysis circuit. In addition, we have reported that the estimated dialysance of citrate was around 100ml/min. Based upon these previous data, the optimum Ca++ concentration in dialysate was investigated in four modalities of dialysate with different Ca++ concentrations, varying from 0 to 1.5mM, in hemodialysis with anticoagulation by citrate. In the cases of dialysate Ca++ concentrations of 0 and 0.5mM, the Ca++ concentration in the circuit was suppressed to as low as less than 0.6mM, which has previously been proved to be enough to conduct hemodialysis without clotting problems. In contrast, in dialysate with Ca++ concentrations of 1.0 or 1.5mM, the Ca++ concentration in the venous site failed to be lowered. Therefore, the superity of the dialysate Ca++ concentrations of 1 and 0.5mM was discused. From a practical point of view, we concluded that in the hemodialysis by anticoagulation with citrate the optimum Ca++ concentration in the dialysate should be 0.5mM rather than Ca++ free.