OBJECTIVE: To discuss blood collection tubes with different additives and their effects on the testing results of alcohol concentration in blood samples. METHODS: Blood samples from 10 volunteers were collected 2 hours after drinking with seven different types of disposable vacuum blood collection tubes, including ordinary tube without anticoagulant, coagulant tube, separating gel-coagulant tube, sodium citrate (1:4) tube, sodium citrate (1:9) tube, sodium citrate (9:1) tube and EDTA-K2 tube. The alcohol concentrations in these blood samples were analyzed by headspace gas chromatography. RESULTS: The concentration testing results of the same blood samples in different types of tubes were different from one to another. The sequence was as follows: separating gel-coagulant tube > coagulant tube > ordi- nary tube without anticoagulant > EDTA-K2 tube> sodium citrate (1:9) tube> sodium citrate (1:4) tube, whereas the results of the same blood sample in sodium citrate (1:9) tube and sodium citrate (9:1) tube showed no obvious difference. CONCLUSION It is better to collect a suspicious drunk driver's blood sam- ple using a disposable vacuum blood collection tube, with the EDTA-K2 tube being preferred.
Anticoagulants ; Blood Specimen Collection/methods* ; Citrates ; Ethanol/blood* ; Humans ; Sodium Citrate

OBJECTIVE: To determine the efficacy and safety of sodium bicarbonate, citric acid, sodium citrate, and tartaric acid (compound drug) in comparison to potassium citrate in the treatment of kidney stones.

METHODS: Prospective randomized controlled trial of patients with kidney stones recruited from February to October 2011 at Out-patient Department was conducted. Ninety subjects, consented and eligible, were enrolled in this study. Random allocation of subjects into two groups was done using computer generated randomization. Subjects assigned to group I were treated with the compound drug(12 grams/day); while group II subjects were given potassium citrate(60mEq/day) for 6 weeks. Urinary pH levels were examined weekly and the effect of medical treatment on stone size changes was evaluated by ultrasonography every two weeks in the six-week treatment period. Intention to treat analysis was done with 95% confidence level(CI). Statistical analysis of results was determined using analysis of variance (ANOVA) with multiple repeated measures for between group urinary pH changes and chi square for between groups difference in stone size changes.

RESULTS: A total of 74 subjects completed the study with a dropout rate of 18%, which was mainly due to geographic and financial reasons. Demographic and baseline stone characteristics of both groups were not significantly different. Treatment outcome between the two groups based on stone size changes (in general and both radiolucent and radioopaque stones subgroups) did not show any significant statistic difference. The pH level changes over six-week treatment period between the two groups showed a total mean pH difference of 0.445, (95% CI: 0.213, 0.677), which was statistically significant (P<0.001) in favor of Group I. Both treatment regimens were well-tolerated with very few non-serious medication adverse effects.

CONCLUSION:  Urinary alkalinization with sodium bicarbonate, citric acid, sodium citrate, and tartaric acid is a well-tolerated and highly effective treatment resulting in dissolution of non-obstructing kidney stones and is comparable to the gold standard potassium citrate.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; KIDNEY CALCULI ; NEPHROLITHIASIS ; UROLOGIC DISEASES ; KIDNEY DISEASES ; SODIUM BICARBONATE ; CITRIC ACID ; SODIUM CITRATE ; TARTARIC ACID ; POTASSIUM CITRATE ; INORGANIC CHEMICALS ; ORGANIC CHEMICALS ; TREATMENT OUTCOME ; SAFETY

OBJECTIVE: To assess the effect of vitamin K2 in addition to risedronate on postmenopausal osteoporosis METHOD: We enrolled 21 postmenopausal osteoporosis women (age: 65.2+/-7.8 years). Ten subjects received risedronate (35 mg, weekly) and vitamin K2 (45 mg, daily) and eleven subjects only received risedronate. They all received calcium citrate 2,130 mg and vitamin D 600 IU daily. The duration of treatment was 7.7+/-1.4 months. Bone mineral density (BMD) of lumbar spine and both femurs, serum osteocalcin and urine deoxypyridinoline were examined at baseline and after treatment. RESULTS: After treatment, BMD, serum osteocalcin and urine deoxypyridinoline were improved in each group but there was no statistical difference between the groups. CONCLUSION: There was no evidence of the benefit of vitamin K2 in addition to risedronate in bone metabolism on postmenopausal osteoporosis.
Bone Density ; Calcium Citrate ; Female ; Femur ; Humans ; Metabolism ; Osteocalcin ; Osteoporosis, Postmenopausal* ; Risedronate Sodium ; Spine ; Vitamin D ; Vitamin K 2* ; Vitamins*

BACKGROUND: Nitrovasodilators are known to induce hypotension through activating nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway. By inhibiting the breakdown of cGMP, sildenafil citrate may augment the nitrovasodilator-induced hypotension. The present study was aimed to investigate whether sildenafil would reduce the dose of nitrovasodilators needed to induce the hypotension. METHODS: Ten mongrel dogs were acutely instrumented with a femoral artery catheter and a pulmonary artery catheter. They were intravenously given sodium nitroprusside (SNP; 1-16ng/kg/min) or nitroglycerin (NTG; 2 - 32ng/kg/min) to induce hypotension. The study was composed of two occasions in each animal: one with sildenafil pretreatment (1 mg/kg IV followed by 0.3 mg/kg/h) and the other without to serve as control, one week apart. Hemodynamic parameters were continuously monitored. Plasma cGMP concentrations were measured by radioimmunoassay. RESULTS: Both SNP and NTG produced dose-dependent reductions in mean arterial pressure (MAP) without affecting the heart rate in both the control and sildenafil groups. Systemic vascular resistance index (SVRI) and mean pulmonary arterial pressure were also decreased. However, SNP caused a greater reduction of MAP and SVRI in the sildenafil group than in the control group; whereas, NTP caused similar reductions in both groups. Neither SNP nor NTG altered the plasma cGMP concentrations. Sildenafil increased the plasma cGMP concentration, which was further increased by SNP, but not by NTG. CONCLUSIONS: These results indicate that sildenafil may reduce the dose of SNP, but not that of NTG needed to produce hypotension in the dog. The potentiation of SNP-induced hypotension by sildenafil may be related to an augmented cGMP effect.
Animals ; Arterial Pressure ; Catheters ; Citric Acid* ; Dogs* ; Femoral Artery ; Guanosine Monophosphate ; Heart Rate ; Hemodynamics ; Hypotension* ; Nitric Oxide ; Nitroglycerin ; Nitroprusside* ; Plasma ; Pulmonary Artery ; Radioimmunoassay ; Sodium* ; Vascular Resistance ; Sildenafil Citrate

OBJECTIVES: Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment. METHODS: Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline. RESULTS: A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41). CONCLUSIONS Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans ; Citric Acid/adverse effects* ; Prospective Studies ; Sodium Citrate ; Hemorrhage/chemically induced* ; Citrates/adverse effects* ; Anticoagulants/adverse effects* ; Renal Dialysis/adverse effects*

The prevalence of kidney stone disease is increasing, and newer research is finding that stones are associated with several serious morbidities. These facts suggest that emphasis needs to be placed not only on stone treatment but also stone prevention. However, there is a relative dearth of information on dietary and medical therapies to treat and avoid nephrolithiasis. In addition, studies have shown that there are many misconceptions among both the general community and physicians about how stones should be managed. This article is meant to serve as a review of the current literature on dietary and drug therapies for stone prevention.
Allopurinol/therapeutic use ; Calcium Oxalate/analysis ; Cystine/analysis ; *Diet ; Humans ; Kidney Calculi/chemistry/*prevention & control ; Potassium Citrate/therapeutic use ; Sodium Chloride Symporter Inhibitors/therapeutic use ; Uric Acid/analysis ; Urological Agents/*therapeutic use

Adult Fanconi syndrome is characterized by variable abnormalities caused by renal proximal transport defects, resulting in glycosuria, aminoaciduria, bicarbonaturia, uricosuria and phosphaturia. A 57-year-old man with kappa-light chain multiple myeloma, undergoing chemotherapy with prednisolone and melphalan for 17 month, was admitted with spontaneous femoral neck fracture and was consulted due to polyuria and refractory metabolic acidosis immediately after hemiarthroplasty. The laboratory values showed normal anion gap metabolic acidosis with normal urinary anion gap, hypokalemia, hypouricemia, hypophosphatemia at the time of consultation. After partial correction of acidemia, the fractional excretion of HCO3- was 11.9%, it was interpreted as proximal renal tubular acidosis. 24-hour urine collection showed increased level of excretion for most aminoacids. Diffuse osteopenia and multiple compression fractures on spine were detected on radiological examinations. Also, osteoporosis and osteomalacia was suggested during his clinical course. After the diagnosis of Fanconi syndrome was made, treatment was started with sodium bicarbonate, potassium citrate, calcitriol, calcium carbonate along with phosphate rich diet. Laboratory abnormalities were corrected and refractory multiple bone pain was ameliorated with these treatment.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Renal Tubular ; Adult ; Bone Diseases, Metabolic ; Calcitriol ; Calcium Carbonate ; Diet ; Fanconi Syndrome ; Femoral Neck Fractures ; Fractures, Compression ; Glycosuria ; Hemiarthroplasty ; Humans ; Hypokalemia ; Hypophosphatemia ; Hypophosphatemia, Familial ; Melphalan ; Middle Aged ; Multiple Myeloma ; Osteomalacia ; Osteoporosis ; Polyuria ; Potassium Citrate ; Prednisolone ; Sodium Bicarbonate ; Spine ; Urine Specimen Collection