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Citrasate Concentrate
Is a Very Cost-Effective Answer to Patients with Bleeding or Clotting

Patient Benefits Include:

- Eliminates or Reduces Heparin need in RF patients (1)
- Reduces post-dialysis Bleeding (2)
- Increases dialysis dose Kt/V (3)
- Corrects Acidosis (4)
- Lowers dialysis-related Inflammation (5)
Introduction
Advanced Renal Technologies Inc. WA. USA (ART) has developed a new dialysate formulation that
addresses patient’s needs and brings treatment to a more effective level. Containing Citric Acid as
the acidifying agent, it is the first major change in dialysate formulation in over 30 years, breaking
away from traditional formulations that contain acetic acid. It is cleared for use by the FDA for all
patients, it is already on the market and is in use in many clinics around the world.

Comparison of Dialysates (list given is an example, it can be modified to your needs)

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Product Measure Citrasate Dialysate (CE) Acetic Acid Dialysate
Sodium mmol/l 138 138
Potassium mmol/l 2,0 2,0
Calcium mmol/l 1,25 1,25
Magnesium mmol/l 0,5 0,5
Chloride mmol/l result result
Acetate mmol/l 0,3 4,0
Citrate mmol/l 0,8 -
Bicarbonate mmol/l 37 37
Glucose g/l 1,0 1,0

References
1. Heparin Free Slow Low Efficiency Dialysis (SLED) Using Citrate Dialysate (CD) Is Safe and Effective S. Ahmad, A. Tu
March 7–10, 2007, San Diego, Calif.
2. Fifty-five Percent Heparin Reduction is Safe with Citrate Dialysate in Chronic Dialysis Patients Robert J Kossmann,
MD, Robin Callan, LLM and Suhail Ahmad, MD ASN's 39th Annual Renal Week Meeting November 2006
3. Increased Dialysis Dose and Decreased Concentration of Beta-2 Microglobulin with Citrate Dialysate Robert J
Kossmann, MD, Robin Callan, LLM and Suhail Ahmad, MD. ASN's 39th Annual Renal Week Meeting November 2006
4. Increased dialyzer efficiency using a dialysate containing citric acid in place of acetic acid. Ahmad S, Callan R, Cole JJ,
Blagg CR. ASN, Miami, Fla., November 1999.
5. Interleukin 1- β Production Before & After Bicarbonate Dialysis (BCD), Hemodiafiltration (HDF), Acetate Free
Biofiltration (AFB) in 8 HD Pts & 14 Healthy Controls Higuchi et al: Ther Apher &Dial,2004;8:460-7)

For full articles, more abstracts, posters and additional scientific information please visit ART´s
website at: www.citrasate.com

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Citrasate is a Registered Trademark of Advanced Renal Technologies. US Patents 5.252.213 and 6.610.206
European Patent 1124567 and others applied for
Citrasate® Provides better Treatment for All Hemodialysis Patients
Heparin free Dialysis (1)
Management of postsurgical and trauma patients with increased risk of bleeding limits the use of heparin, making
the dialysis especially challenging. The alternatives to heparin therapy in this group are limited to periodic flushes
of the circuit or to regional citrate anticoagulation. Although widely used, line flushing is relatively ineffective and
increases fluid load to the patient. The alternative, regional citrate anticoagulation, is difficult to deliver properly
and expensive to set up and monitor. Both methods involve significant additional effort on the part of the staff.

Bleeding >15 minutes after dialysis (2)

Systemic heparinizaton during hemodialysis (HD) is associated with multiple risks including bleeding
complications. A study has been conducted to determine whether heparin can be safely reduced in chronic HD
patients using Citrate Dialysis (CD). After switching the patients to CD and reducing their heparin dose (55%
reduction), prolonged bleeding reduced with no reported instances of bleeding and Kt/V increased by > 5%.

Dose of dialysis (3)

Furthermore, in patients receiving uncomplicated, "routine dialysis," the goal is to optimize treatment by
increasing the dose of dialysis and enhance middle molecule clearance within the constraints of available time
and cost. This study suggests that the anticoagulation effect of citrate keeps the dialyzer fibers and pores open
and is responsible for the increased removal of urea and beta-2 microglobulin.

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The patented Citrasate is CE marked in the EU, and available through Manufacturers and
Distributors selected by Advanced Renal Technologies, Inc. For Baltic States and Finland please
contact:
Finland villem.aruoja@renalfarma.com
Estonia villem.aruoja@renalfarma.com
Zirmunu 139a, LT-09120 Vilnius Latvia krisjanis.ritovs@renalfarma.com
Lithuania, tel. +37052051452 Lithuania vytautas.jucys@renalfarma.lt

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Citrasate is a Registered Trademark of Advanced Renal Technologies. US Patents 5.252.213 and 6.610.206
European Patent 1124567 and others applied for