Naslov
Falsely decreased ionized calcium in a dialysis patient

Autori
Lukić, Iva ; Lapić, Ivana ; Fressl Juroš, Gordana ; Brunetta Gavranić, Bruna ; Rogić, Dunja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Biochemia medica / Šimundić, Ana-Maria - Zagreb, 2012, A185-A185

Skup
2nd European Joint Congress of EFLM and UEMS

Mjesto i datum
Dubrovnik, Hrvatska, 10.10.2012. - 13.10.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
dialysis, ionized calcium, heparin induced thrombocytopenia, citrate

Sažetak
Background: Administration of an anticoagulant is required with patients on haemodialysis to prevent thrombosis of the haemodialysis catheter. With patients suffering from heparin induced thrombocitopenia, heparinization is contraindicated and therefore, citrate is used as an alternative. Materials and methods: A 72-year old female patient suffering from kidney failure attending haemodialysis for 25 years has been chosen for this report. Last year the patient was diagnosed with heparin induced thrombocitopenia and therefore catheter-locking in the interdialytic period was performed with citrate as the anticoagulant. Before the haemodialysis and immediately after the removal of the catheter-locking solution, blood sampling for routine laboratory tests was performed. Concentration of ionized calcium was determined potentiometrically using the point- ofcare analyzer RapidLab 1265 (Siemens, Germany). Results: The concentration of ionized calcium was measured prior to two haemodialysis treatments and the results were 0.33 mmol/L and 0.37 mmol/L, respectively. The patient, however, did not suffer from any symptoms of hypocalcemia. After the haemodialysis, ionized calcium was determined again, and its values were within the reference range (1.18–1.32 mmol/L). Conclusion: The patient not suffering from any clinical symptoms of hypocalcemia and the concentration of ionized calcium being within the reference range after haemodialysis, indicates that a preanalytical error has occured. It is highly probable that the removal of the citrate solution from the catheter was not complete, which led to falsely decreased values of ionized calcium due to the capacity of citrate to chelate calcium ions.

Izvorni jezik
Engleski

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