Using disodium monohydrogen phosphate to prepare a phosphate‐enriched hemodialysate

Sam, Ramin; Kjellstrand, Carl M.; Doherty, Chav; Ing, Todd S.

doi:10.1111/hdi.12075

Cited by 5 publications

(5 citation statements)

References 4 publications

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“…The dialysate can be used as a vehicle for the administration of various compounds. Phosphate-enriched dialysate has been used for short-term phosphate supplementation in certain patients [ 102 ]. Some years ago, l -carnitine was administered via dialysate to maintain tissue carnitine levels [ 103 ].…”

Section: Future Developmentsmentioning

confidence: 99%

Optimizing haemodialysate composition

et al. 2015

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Survival and quality of life of dialysis patients are strictly dependent on the quality of the haemodialysis (HD) treatment. In this respect, dialysate composition, including water purity, plays a crucial role. A major aim of HD is to normalize predialysis plasma electrolyte and mineral concentrations, while minimizing wide swings in the patient's intradialytic plasma concentrations. Adequate sodium (Na) and water removal is critical for preventing intra- and interdialytic hypotension and pulmonary edema. Avoiding both hyper- and hypokalaemia prevents life-threatening cardiac arrhythmias. Optimal calcium (Ca) and magnesium (Mg) dialysate concentrations may protect the cardiovascular system and the bones, preventing extraskeletal calcifications, severe secondary hyperparathyroidism and adynamic bone disease. Adequate bicarbonate concentration [HCO3−] maintains a stable pH in the body fluids for appropriate protein and membrane functioning and also protects the bones. An adequate dialysate glucose concentration prevents severe hyperglycaemia and life-threating hypoglycaemia, which can lead to severe cardiovascular complications and a worsening of diabetic comorbidities.

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Section: Future Developmentsmentioning

confidence: 99%

Optimizing haemodialysate composition

et al. 2015

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“…Phosphate-enriched dialysate has been used for short-term phosphate supplementation in certain patients. 25 L-carnitine has also been administered via dialysate to maintain tissue carnitine levels. 26 FPC (Triferic) is the first drug approved in the United States as an iron replacement product to be added to the dialysate for the maintenance of hemoglobin in patients receiving chronic hemodialysis.…”

Section: Discussionmentioning

confidence: 99%

“…Hemodialysate can be used as a vehicle for administration of various compounds. Phosphate‐enriched dialysate has been used for short‐term phosphate supplementation in certain patients 25 . L‐carnitine has also been administered via dialysate to maintain tissue carnitine levels 26 .…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and Safety of Intravenous Ferric Pyrophosphate Citrate: Equivalence to Administration via Dialysate

Marbury

Heuveln

Horst

et al. 2022

The Journal of Clinical Pharma

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Ferric pyrophosphate citrate (FPC) is indicated to maintain hemoglobin in patients with stage 5 hemodialysis-dependent chronic kidney disease on chronic hemodialysis by addition to the dialysate. An intravenous (IV) FPC presentation containing 6.75 mg of iron in 4.5 mL was developed. The objective was to establish the equivalence of iron delivery via dialysate and IV infusion using a pharmacokinetic approach. An open-label, randomized, multiple-period, single-dose, crossover study was conducted in 27 patients with CKD-5HD. Each patient received (1) a basal iron profile over 12 hours, (2) FPC 6.75 mg Fe IV predialyzer, (3) FPC 6.75 mg Fe IV postdialyzer, and (4) FPC 2 μM (110 μg Fe/L of hemodialysate). Serum and plasma iron was analyzed for total Fe and transferrin bound iron (TBI). Equivalence was determined by comparing maximum observed concentration and area under the concentration-time curve from time 0 to the last observation of 110 μg Fe/L of hemodialysate (reference) and test treatments Fe predialyzer and postdialyzer iron profiles. The main outcome measure was the measurement of bioequivalence between the reference and test treatments. Bioequivalence parameters showed that infusion of FPC iron IV, predialyzer and postdialyzer delivered equivalent iron as via hemodialysate. The increment in serum total Fe from predialysis to postdialysis was the same as observed in the long-term clinical studies of FPC. FPC IV was well tolerated. IV infusion of 6.75 mg iron as FPC during 3 hours of HD delivers an equivalent amount of iron as when Triferic is delivered via hemodialysate. The IV presentation of FPC extends the ability to provide FPC iron to all patients receiving hemodialysis or hemodiafiltration.

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“…Kaysen et al (2003) [18], Stenvinkel et al, (2002) [19], & Kaysen, (2001) [20] indicated that sugar levels between 100 & 200 mg/dL in dialysate may or may not have a deleterious effect on triglyceride metabolism. Hyperglycemia may operate as a proinflammatory trigger if dialysate glucose values of 200 mg/dL are used [18,19,20]. For the first time, the FDA has accepted a dialysate containing 100 mg/dL glucose.…”

Section: Calcium Dialysatementioning

confidence: 99%

Individualising / personalizing hemodialysate composition

Arya

Priya²,

Varghese

2022

ijhs

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The effectiveness of the haemodialysis (HD) treatment directly affects the survival and quality of life of dialysis patients. In this regard, the composition of the dialysate, including the quality of the water, is very important. Normalizing the plasma electrolyte and mineral concentrations before to dialysis while reducing significant changes in the patient's intradialytic plasma concentrations is one of HD's main goals. For the purpose of avoiding intra- and interdialytic hypotension as well as pulmonary edoema, adequate sodium (Na) and water elimination is essential. The cardiovascular system and the bones may be protected by having the right amounts of calcium (Ca) and magnesium (Mg) in the dialysate. This will help to avoid extraskeletal calcifications, severe secondary hyperparathyroidism, and adynamic bone disease. A steady pH in body fluids is required for proper protein and membrane function as well as bone protection, and this is achieved by maintaining an adequate bicarbonate concentration [HCO3]. A sufficient dialysate glucose concentration prevents life-threatening hypoglycemia and severe hyperglycemia, which can cause serious cardiovascular problems and exacerbate diabetic comorbidities.

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Using disodium monohydrogen phosphate to prepare a phosphate‐enriched hemodialysate

Cited by 5 publications

References 4 publications

Optimizing haemodialysate composition

Optimizing haemodialysate composition

Pharmacokinetics and Safety of Intravenous Ferric Pyrophosphate Citrate: Equivalence to Administration via Dialysate

Individualising / personalizing hemodialysate composition

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