Figure 1:

A simplified KRT circuit with RCA for CVVH, CVVHDF and SLED. The low concentration citrate solution is infused in pre-dilution in proportion to Qb, aiming at a target estimated citrate concentration in the hemofilter of 2.5–3 mmol/L. In CKRT modalities, a calcium-free and bicarbonate and phosphate containing solution acting as post-dilution (A) and/or dialysis fluid (B) was adopted and set to prescribed dialysis dose of 30–35 mL/kg/h. In PIKRT, as SLED-f, the same solution was used as dialysis fluid and combined with a standard KRT solution for post-dilution replacement fluid (C) for a prescribed effluent volume of 100 mL/min. In all KRT modalities, an infusion of calcium chloride (10% solution) in a central venous line was scheduled to maintain the systemic ionized calcium (s-Ca²⁺) within the normal range. Qb, blood flow rate.