Phoxilium vs Hemosol-B0 for continuous renal replacement therapy in acute kidney injury

Electrolytes-Enriched Hemodiafiltration Solutions for Continuous Renal Replacement Therapy in Acute Kidney Injury: A Crossover Study

“…The burden of hypophosphatemia has been well documented in critically ill patients including complications such as respiratory insufficiency, heart failure, arrhythmias, rhabdomyolysis, neuropathy and thrombocytopenia [24][25][26] , justifying the benefits of preventing it during CRRT treatment as we did by electrolytes-enriched solutions instead of correcting it by intravenous supplementation. Our results corroborated previous studies that have investigated similar dialysis and replacement fluids [12,13] . Using regional citrate anticoagulation, phosphate-containing fluid solution also reduced CRRT-related phosphate depletion [27] .…”

“…Based on rates of the occurrence of hypophosphatemia during CRRT from 15 to 50% with conventional solutions [7] and approaching 0% with Phoxilium [12,13] , and on the effects of order use of solutions, we required a sample size of 10 subjects for statistical significance at p < 0.05 with a power of 90%. First, we performed a descriptive analysis by computing frequencies and percentages for categorical data, means, standard deviations, quartiles and extreme values for continuous data.…”

“…Most of the previous studies have documented their impact in serum phosphate levels. Broman et al [12] and Chua et al [13] showed that such a dialysis solutions reduce the variability of serum phosphate levels and the incidence of hypophosphatemia. However, these studies are mainly retrospective, and different doses of RRT have been used among patients studied.…”

Continuous Renal Replacement Therapy for Acute Kidney Injury Using Phosphate Containing Fluid is Associated With Greater Biochemical Derangement than Conventional Fluid

“…Using Phoxillium removed the need for phosphate supplementation. Our data are consistent with the important data published by Chua et al 10 that identified metabolic acidosis and hypocalcaemia amongst selected patients receiving CRRT in whom Phoxilium had been introduced to at clinicians discretion. However, in contrast to their finding that plasma [PO 4 3-] was better maintained in patients receiving Phoxilium, we found that that the use of Phoxilium was associated with a greater proportion of time spent outside the normal plasma range of [PO 4 3-].…”

“…9 Phoxilium is a phosphate and potassium containing CRRT fluid, introduced to mitigate the risk of hypophosphataemia and need for potassium supplementation. 10 The composition of Hemosol-B0 and Phoxilium are compared in Table 1 10 It is common practice in most intensive care units to identify a default fluid to be used for CRRT. The biochemical consequences of replacing Hemosol-B0 with Phoxilium as the default CRRT fluid to an unselected patient cohort, and the potential benefit of minimizing handling of concentrated K + solutions (identified as a high risk intervention by organizations in Australia, Canada, the US and UK 11,12 ), remain unknown.…”