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Renal Disease; Fluid and Electrolyte Disorders
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
If stone-forming substances in the urine, such as calcium phosphate, reach high enough concentrations to exceed their solubility, they come out of solution to form stones. Urinary stasis, infection and indwelling catheters all promote stone formation. Citrate, which is present in urine, inhibits stone formation by forming a soluble complex with calcium. Nephrocalcinosis describes diffuse renal calcium deposition, mainly in the medulla, and causes include hyperparathyroidism, distal renal tubular acidosis and medullary sponge kidney.
Biochemistry of Buffering Capacity and Ingestion of Buffers In Exercise and Athletic Performance
Published in Peter M. Tiidus, Rebecca E. K. MacPherson, Paul J. LeBlanc, Andrea R. Josse, The Routledge Handbook on Biochemistry of Exercise, 2020
Bryan Saunders, Guilherme G. Artioli, Eimear Dolan, Rebecca L. Jones, Joseph Matthews, Craig Sale
There is a perceived lower risk of GI discomfort compared to sodium bicarbonate (91, 95), although side effects still occur with sodium citrate. The most common symptoms include stomach cramps, bloating, nausea, vomiting, urge to defecate, diarrhoea, thirst, and headache (84, 109, 110); essentially the same side effects as sodium bicarbonate. Early studies reported no side effects from sodium citrate doses ranging from 0.1 to 0.5 g·kg−1BM (62, 74, 89), although these investigations failed to adequately record the incidence and severity of side effects, meaning that mild symptoms went unnoticed. Later studies reported side effects with doses of 0.5 g·kg−1BM (83, 84, 110), but GI distress was not experienced by volunteers in all studies (125). Symptom prevalence and severity increase in a dose-dependent manner for intakes of 0.5, 0.7, and 0.9 g·kg−1BM (124). Key moderators of these effects appear to be the volume of fluid supplied with the supplement and the time permitted to consume the fluid; concentrated solutions with a higher osmolality are more likely to result in GI distress (65). Higher doses potentiate these symptoms (124), and lower or staggered doses may reduce symptom prevalence and/or severity (74). Side effects may also have an ergolytic effect on exercise, particularly if sodium citrate is ingested 60–90 minutes pre-exercise, which means that individuals would perform exercise at the moment of the highest risk of GI distress and without reaching peak blood alkalosis (124).
Fuel Metabolism in the Fetus
Published in Emilio Herrera, Robert H. Knopp, Perinatal Biochemistry, 2020
The consequence of this poor fatty acid oxidation is the low citrate concentration, which results in activation of glucose utilization for fetal heart metabolism. Citrate, which is generated in the metabolism of fatty acids, actually limits glycolysis by inhibiting phosphofructokinase—a key regulatory enzyme of this pathway. Therefore the low citrate concentration facilitates glucose metabolism, which becomes the primary substrate for energy production in the fetal heart. Energy production is strictly dependent in the earliest stages of development upon the rate of glycolysis. However, there is a shift at near midgestation from the rather anaerobic conditions to glucose oxidation of early gestation to the aerobic conditions which take place, in addition to glycolysis, for energy production during late gestation.19
Platelet-derived respiratory-competent mitochondria transfer to mesenchymal stem cells to promote wound healing via metabolic reprogramming
Published in Platelets, 2022
Enlin Chen, Zhe Chen, Linxi Chen, Xiaoling Hu
Citrate, the product of the TCA cycle, provides a carbon source for the synthesis of fatty acids, which is closely related to the promotion of angiogenesis. Moreover, citrate can promote the growth of endothelial cells, the release of angiogenic factors, and angiogenesis by regulating the metabolic state of vascular endothelial cells. Levoux et al. [1] also found that citrate produced by the TCA cycle of platelet-derived respiratory-competent mitochondria may be exported into the cytosol of MSCs to provide fuel for the ATP citrate lyase (ACLY) enzyme, which initiates the synthesis of fatty acids and promotes angiogenesis. When MSCs are incubated with platelets, they show a high level of fatty acid synthesis (ACLY, ACC, and FAS), which promotes the expression and secretion of angiogenic factors such as vascular endothelial growth factor and hepatocyte growth factor. The Fas inhibitor C75 strongly reverses MSC-mediated angiogenesis, indicating that the stimulation of angiogenesis by MSCs requires de novo fatty acid synthesis, although the mechanism is unknown. The dependence of citrate on fatty acid synthesis stimulates angiogenesis and improves wound healing properties. Fatty acid synthesis and ATP generation promotes the release of angiogenic factors to achieve wound healing, which provides a new, effective, and reliable treatment method for tissue injury repair.
Clot activators and anticoagulant additives for blood collection. A critical review on behalf of COLABIOCLI WG-PRE-LATAM
Published in Critical Reviews in Clinical Laboratory Sciences, 2021
G. Lima-Oliveira, L. M. Brennan-Bourdon, B. Varela, M. E. Arredondo, E. Aranda, S. Flores, P. Ochoa
Sodium citrate is commonly used as a solution of dihydrate trisodium citrate. It is a nontoxic anticoagulant that converts Ca++ ions to the non-ionized form and prevents coagulation (Figure 4) [92]. In the clinical laboratory, it is employed mainly for preventing blood coagulation for hemostasis testing, platelet studies, and erythrocyte sedimentation rate. While additives may be liquid or dry, the latter form is preferable because the water of the liquid additives can diffuse out the plastic and jeopardize the blood/additive ratio. However, buffered sodium citrate is available only in liquid form. Therefore, manufacturers of evacuated tubes have developed a “double wall” tube system to avoid water loss and to maintain the quality of their product. Briefly the sodium citrate used in evacuated tubes has a pH ∼ 5.8 that requires approximately −40 °C in the crystallization phase of lyophilization, making the process of lyophilization of this additive in evacuated tubes impractical [93].
Lipid Apheresis to Manage Severe Hypertriglyceridemia during Induction Therapy in a Child with Acute Lymphoblastic Leukemia
Published in Pediatric Hematology and Oncology, 2020
Christina Mayerhofer, Carsten Speckmann, Friedrich Kapp, Ulrike Teufel-Schäfer, Wolfram Kluwe, Johanna Schneider, Christian Flotho
Because of severe abdominal pain and the possibility of rapidly developing pancreatitis, we initiated a lipid apheresis on the same day, using a Spectra Optia system (Terumo BCT, Tokyo, Japan) with continuous-flow centrifugation for separation of plasma and cellular components followed by an Evaflux filter as plasma fractionator. Citrate was used for anticoagulation. The procedure was continued at a blood flow rate of 70 ml/min until 4 L (45 ml/kg body weight) of plasma were filtered. After the first lipid apheresis, serum triglycerides levels decreased to 1200 mg/dL and the patient’s condition improved significantly. The initial fasting regimen was switched to lipid-lowering diet (more unsaturated than saturated fatty acids, higher proportion of complex carbohydrates, reduction of mono- and disaccharides, high-fiber cost). After a second lipid apheresis on day 34 the triglyceride levels remained below 500 mg/dL. Retrospectively, the hyponatremia in our patient was an artifact of the lipemic blood samples; the corrected serum sodium value (= measured sodium + 0.2 × triglycerides in g/L)3 was 134.4 mmol/L.