Severa ipocalcemia conseguente all’assunzione orale di citrato in un paziente in emodialisi cronica
DOI:
https://doi.org/10.33393/gcnd.2021.2322Parole chiave:
Hemodialysis, Hypocalcaemia, Oral Citrate, Parapharmaceuticals, Vascular access failureAbstract
We report a case of an 81-year-old man with end stage renal disease (ESRD) in chronic hemodialysis with severe hypocalcaemia secondary to the intake of a parapharmaceutical containing sodium and potassium citrate and in association with poor dialysis efficiency, due to malfunction of the vascular access, which promptly resolved after discontinuation of the supplement. The patient never showed signs or symptoms of hypocalcaemia. This case highlightens the importance of a correct pharmacological reconciliation in dialysis patients in order to avoid the onset of adverse events due to the uncontrolled intake of drugs or parapharmaceuticals.
Riferimenti bibliografici
Simpson DP. Citrate excretion: a window on renal metabolism. Am J Physiol. 1983;244(3):F223-F234. PMID:6338740
Hamm LL. Renal handling of citrate. Kidney Int. 1990;38(4):728-735. https://doi.org/10.1038/ki.1990.265 PMID:2232510
Costello LC, Franklin RB. Plasma citrate homeostasis: How it is regulated; and its physiological and clinical implications. An important, but neglected, relationship in medicine. HSOA J Hum Endocrinol. 2016;1: 005. PMID: 28286881
Tiselius HG, Berg C, Fornander AM, Nilsson MA. Effects of citrate on the different phases of calcium oxalate crystallization. Scanning Microsc. 1993;7(1):381-389. PMID:8316807
Seaton RD, Duncan KA, Pinnick RV, Diederich DA, Wiegmann TB. Regional citrate anticoagulation in chronic hemodialysis patients. Trans Am Soc Artif Intern Organs. 1983;29:414-418. PMID:6673262
Wolfgram DF, Gundu V, Astor BC, Jhagroo RA. Hydrochlorothiazide compared to chlorthalidone in reduction of urinary calcium in patients with kidney stones. Urolithiasis. 2013;41(4):315-322. https://doi.org/10.1007/s00240-013-0568-5 PMID:23660825
Phillips R, Hanchanale VS, Myatt A, Somani B, Nabi G, Biyani CS. Citrate salts for preventing and treating calcium containing kidney stones in adults. Cochrane Database Syst Rev. 2015;(10):CD010057. https://doi.org/10.1002/14651858.CD010057.pub2 PMID:26439475
Monchi M. Citrate pathophysiology and metabolism. Transfus Apheresis Sci. 2017;56(1):28-30. https://doi.org/10.1016/j.transci.2016.12.013 PMID:28073690
Olgaard K, Salusky IB, Silver J. The spectrum of mineral bone disorders in chronic kidney disease. 2nd ed.Oxford. Oxford University Press; 2010:111-114. https://doi.org/10.1093/med/9780199559176.001.1
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