Evidence map›Paper›PMID 39180669›Full record

ArticleArchives of osteoporosis2024

Regional citrate anticoagulation with continuous renal replacement therapy as a cause of hypercalcemia.

Leor Needleman, Michael S Hughes, Pedram Fatehi, Deborah E Sellmeyer

Abstract readCase Reports
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In one paragraph

Article in Archives of osteoporosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Leor NeedlemanDepartment of Medicine, Division of Endocrinology, Gerontology and Metabolism, Stanford University, Stanford, CA, 94305, USA.
Michael S HughesDepartment of Medicine, Division of Endocrinology, Gerontology and Metabolism, Stanford University, Stanford, CA, 94305, USA.
Pedram FatehiDepartment of Medicine, Division of Nephrology, Stanford University, Stanford, CA, 94305, USA.
Deborah E SellmeyerDepartment of Medicine, Division of Endocrinology, Gerontology and Metabolism, Stanford University, Stanford, CA, 94305, USA. dsellme@stanford.edu.

Funding

Stanford Islet Research CoreP30DK116074 · NIDDK · STANFORD UNIVERSITY · PI Seung K Kim · 2017 to 2026
$19.5M
Diabetes, Endocrinology and Metabolism Training GrantT32DK007217 · NIDDK · STANFORD UNIVERSITY · PI Justin Pierce Annes, David Matthew Maahs · 1987 to 2026
$7.2M
Training Research Leaders in Type 1 DiabetesK12DK122550 · NIDDK · STANFORD UNIVERSITY · PI MAAHS, DAVID MATTHEW · 2019 to 2023
$2.1M
NIDDK NIH HHS 5K12DK122550NIDDK NIH HHS P30DK116074NIDDK NIH HHS T32 DK007217
6 · The paper itself

Abstract

clinical relevanceAwareness of the causes of hypercalcemia is essential for timely diagnosis of calcium disorders and optimal treatment. Citrate is commonly used as an anticoagulant during continuous renal replacement therapy (CRRT). Accumulation of citrate in the systemic circulation during CRRT may induce several metabolic disturbances, including total hypercalcemia and ionized hypocalcemia. The aim of the present study is to increase awareness of citrate accumulation and toxicity as a cause of hypercalcemia by relating three cases and reviewing the pathophysiology and clinical implications. OBSERVATIONS: We utilized electronic health records to examine the clinical cases and outlined key studies to review the consequences of citrate toxicity and general approaches to management.

conclusionsCitrate toxicity is associated with high mortality. A safe threshold for tolerating hypercalcemia during citrate anticoagulation is not clearly defined, and whether citrate toxicity independently increases mortality has not been resolved. Greater attention to citrate toxicity as a cause of hypercalcemia may lead to earlier detection, help to optimize the management of systemic calcium levels, and foster interest in future clinical studies.

Indexed as

AnticoagulantsCitric AcidContinuous Renal Replacement TherapyHypercalcemiaAgedCalciumFemaleHumansMaleMiddle AgedAnticoagulantsCalciumCitric AcidContinuous renal replacement therapyHypercalcemiaRegional citrate anticoagulation

Identifiers

PMID39180669

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.