citrate-based dialysate

Citrate-based dialysate is a dialysis solution in which **citrate** replaces **acetate** as the acidifying agent, used in hemodialysis and hemodiafiltration. Citrate acts as a calcium chelator, thereby providing **local anticoagulant effects** via reduction of ionized calcium in the blood compartment of the dialyzer, helping to prevent clotting within the dialysis circuit[1][2][5][7][11]. The solution is further metabolized to bicarbonate in the body, contributing to buffer base balance[7][9]. Clinical advantages compared to conventional acetate-based dialysate include **improved hemodynamic stability** (notably less intra- and post-dialytic hypotension), reduced inflammation, decreased need for systemic anticoagulation (lower heparin dosage), improved dialysis efficiency (greater clearance of urea, creatinine, β-2 microglobulin, phosphate), and potentially improved nutritional status[1][2][3][5][7][9][11]. Some studies report fewer adverse intradialytic events, though mild adverse effects such as muscle cramps or fatigue may occur in a subset of patients[9]. The solution is suitable for patients with contraindications to systemic heparin, those with increased risk of clotting, or patients with cardiovascular instability[3][8]. Widespread use is increasing, particularly under the Citrasate brand.

Brand names

Citrasate

Other names

citrate dialysateCit-DCDFcitrate-containing dialysis fluidcitrate-buffered dialysate