Table 3 Optimization of main electrolyte balance during RCA-CRRT
Electrolyte | Potential derangement | Rationale | Optimization measures |
|---|---|---|---|
Calcium | Hypocalcemia | RCA-RRT are characterized by a negative calcium mass balance requiring calcium supplementation | Calcium supplementation need during RCA-RRT can be significantly reduced by using calcium-containing dialysate and/or replacement fluid |
Magnesium | Hypomagnesemia | RCA-RRT are characterized by a negative magnesium mass balance, especially with the use of low concentration citrate solutions | Magnesium supplementation should be properly ensured during RCA-RRT Magnesium concentration of CRRT solutions dedicated to RCA could be worthy of further optimization according to the protocol adopted |
Phosphorus | Hypophosphatemia | Phosphate depletion is common in critically ill patients, especially during prolonged or continuous RRT modalities | Use of phosphate-containing dialysate and/or replacement fluids, as a variable proportion of dialysis dose, allows to minimize the need for phosphate supplementation |