Thursday August 14, 2008

Q: Citrate is used in continuous renal replacement therapy (CRRT) for extracorporeal anticoagulation. What is the added advantage of using citrate?

Answer: Citrate partially enters the systemic circulation. Apart from being an anticoagulant, citrate is a buffer substrate. The generation of buffer is related to the conversion of sodium citrate to citric acid:

Na3 citrate + 3H2CO3 = citric acid + 3NaHCO3

Citric acid enters the mitochondria and is metabolized in the Krebs cycle, mainly in the liver but also in skeletal muscle and the renal cortex, leaving sodium bicarbonate.

Related Pearl: Citrate in CRRT

Reference: Click to get article

Clinical review: Patency of the circuit in continuous renal replacement therapy- Critical Care 2007, 11:218