Effectiveness of calcium-containing replacement fluids in preventing cardiovascular complications during continu-ous renal replacement therapy
LAI Kai-yuan
ZHU Wei-dong
JIANG Wen-yi
SU Wei-huan
HUANG Shu-ting
Abstract：Background: Continuous renal replacement therapy (CRRT) is frequently applied in critically ill patients with acute kidney injury who are vulnerable to cardiovascular complications. Differences in calcium management during CRRT may affect cardiac electrophysiology and hemodynamic stability, potentially influencing cardiovascular outcomes. Methods: A total of 96 patients receiving CRRT were enrolled in this single-center study between September 2020 and September 2023. Patients were divided into two groups: those receiving calcium-containing replacement fluids (n=46) and those receiving calcium-free fluids (n=50). Clinical outcomes, including major adverse cardiovascular events (MACE), arrhythmias, hypotension, myocardial infarction, sudden cardiac arrest, intensive care units (ICU) stays, and hospital mortality, were compared between the two groups. Results: The calcium-containing group had a significantly lower incidence of MACE (20% vs. 32%, P<0.001) and arrhythmias (8% vs. 17.3%, P=0.010) compared to the calcium-free group. ICU stays were also shorter in the calcium-containing group (11.6±8.8 days vs. 16.6±7.6 days, P=0.004). Hospital mortality showed a trend toward being lower in the calcium-containing group, though this was not statistically significant (0.6% vs. 10.1%, P=0.063). No significant differences were observed in the incidence of hypotension, myocardial infarction, or sudden cardiac arrest. Conclusions: Calcium-containing replacement fluids during CRRT were associated with improved clinical outcomes, including lower rates of MACE and arrhythmias, as well as shorter ICU stays. This simplified approach may be safer and more efficient, but larger studies are needed to confirm these findings and assess long-term outcomes. [S Chin J Cardiol 2025;26(4):219-227]
Keywords：Continuous renal replacement therapyCalcium-containing replacement fluidsMajor adverse car-diovascular events
Publication Date：2025-12-30
Online Publishing Date：2026-01-27(First online date of this platform, not the publication date of the document)
Pages：10( 219-227,266 )