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CRRT fluids

Key Features

Bicarbonate buffered CRRT solutions

Bicarbonate buffered CRRT solutions



Ci-Ca® Dialysate

Ci-Ca® Dialysate Plus

Bicarbonate at a glance:

Two-chamber bag provides ready-to-use solution useable within seconds

100% bicarbonate buffered

Up to four potassium compositions available*

Integrated gas barrier – enables 48 hours in-use stability

*Depending on local product approval

Phosphate-containing CRRT solutions

  • Ci-Ca® Dialysate Plus
  • multiPlus

During an effective CRRT treatment the removal of uremic toxins from patient’s blood is desirable, but important nutrients such as glucose and phosphate are also lost. To limit the loss of glucose, modern CRRT solutions contain a near physiological glucose concentration. Following the same principle, the negative results of an excessive phosphate loss can be avoided. multiPlus is an advanced CRRT solution containing a physiological phosphate concentration, that prevents excessive reduction of phosphate during CRRT treatment and thus prevents the formation of hypophosphatemia due to CRRT with its negative implications for the patients.


Ci-Ca® Dialysate Plus solution bag

Possible clinical results of hypophosphatemia:1

  • Apnea
  • Limitation of cardiac capacity
  • Leukocyte failure
  • Rhabdomyolysis
  • Hemolysis
  • Diabetic ketoacidosis
  • CNS dysfunction

Ci-Ca Dialysate

Ci-Ca® Dialysate K2 / K4

Flexibility for Ci-Ca® treatments

  • Two potassium concentrations (2 and 4 mmol/l) available*
  • Adaptation of the serum potassium level according to the conditions encountered during the course of a CRRT treatment results in increased treatment flexibility

Ci-Ca® Dialysate K2 solution bag

*Depending on local product approval

The majority of patients with renal failure suffer from increased serum potassium levels, as the healthy kidney is responsible for about 90% of the potassium excretion. At the start of a CRRT, it is often necessary to normalize the patient’s potassium levels. During the course of the treatment it is important to concentrate on the stabilization of the potassium concentration within the physiological range of 3.5 – 4.5 mmol/L.

Ci-Ca® Solutions

For both therapy phases a Ci-Ca® Dialysate with an appropriate potassium concentration is available. Ci-Ca® Dialysate K2 with 2 mmol/L potassium and Ci-Ca® Dialysate K4 with 4 mmol/L potassium. These allow changing of the potassium concentration in the dialysate during the course of the treatment.

Phosphate containing variants

Variants of both potassium concentrations ( 2 and 4 mmol/l) are available containing phosphate: for more, see “Ci-Ca® Dialysate Plus”.

Ci-Ca® Dialysate Plus

With the physiological phosphate concentration of 1.25 mmol/L phosphate, Ci-Ca® Dialysate Plus inherently contributes to stabilizing serum phosphate concentration in the physiological range and thus easing the medically essential phosphate management and thereby further adding to the safety of Ci-Ca® therapy.


Ci-Ca® Dialysate Plus solution bag

  • Ci-Ca® Dialysate Plus — Easing phosphate management
  • Fully integrated citrate anticoagulation with multiFiltrate Ci-Ca®
  • Virtually interruption-free CRRT: High efficacy & easy handling
  • Inherent stabilization of serum phosphate concentration
Sodium Citrate 4% - Citrate solution for Ci-Ca® therapy

The citrate solution impedes coagulation by forming chelate complexes with the ionized calcium of the extracorporeal blood.

  • 4% citrate solution and Ci-Ca® Dialysate compositions are concerted to each other

  • The citrate bag is equipped with a special connector to match with Ci-Ca® cassette citrate line and to avoid misconnections


multiBic® – Always the right solution

Sophisticated and convenient — The multiBic® 5 liter bag has many advantages

Bicarbonate-based solutions can be used in all patients with acute kidney injury; they are particularly advantageous in the following situations:

In mechanically ventilated patients and in patients with a poor oxygen supply since the lactate metabolism requires oxygen

In lactic acidosis since here the endogenously produced lactate is no longer sufficiently metabolized

In existing metabolic acidosis since the buffer effect of bicarbonate is present immediately

When performing CRRT at high exchange rates, as the use of lactate-based solutions would result in an additional lactate load

When time is of the essence, every convenience helps. For example, the multiBic® double chamber bag with diagonal peel seam for simple handling. The sophisticated gas barrier helps to keep the ready-to-use bicarbonate solution stable and enables the long in-use time of 48 hours.

multiBic® at a glance

Mixing the two components provide

100% bicarbonate-buffered hemofiltration solution

Always the right solution

4 different potassium concentrations

Increased solution stability, usable for up to 48 hrs

Improved gas barrier

Simpler handing

Bag geometry with diagonal peel-seam

PVC, latex and DEHP-free, environmentally friendly

Manufactured with 'biofine' material

Improved monitoring

Through the clear transparent foil

Easier transport

New, comfortable handle

Addition of medication possible

Injection port


multiPlus – CRRT solution with phosphate

multiPlus solution bag

Preventing the formation of Hypophosphatemia

The treatment of renal failure with a phosphate-free dialysis solution results in a considerable reduction of the serum phosphate concentration and necessitates the substitution of phosphate. The development of hypophosphatemia can be prevented by the use of a dialysis solution containing phosphate. A separate adjustment of the phosphate substitution for the efficacy of the renal replacement therapy is then not required. Thereby complications connected to over- or under-dosing of the substituted amount of phosphate are avoided2. Thus, a dialysis solution containing phosphate should be used preferentially to separate phosphate substitution3.

The advantages at a glance

  • Inherent stabilization of serum phosphate concentration
  • Prevents the formation of hypophosphatemia and results in normalization of the serum phosphate concentration
  • Phosphate and glucose ensure the adequate provision of energy rich components for metabolic processes
  • Safety and cost efficiency – separate phosphate substitution is unnecessary
  • Simple handling due to the 5 liter dual chamber bag

Prescribing Information

1 Amanzadeh J. & Reilly RF Jr., Nature Clinical Practice Nephrology (2006); 2: 136 - 148

2 Lentz R. et al., Annals of Internal Medicine (1978); 89: 941 - 944

3 Gatchalian R. et al., American Journal of Kidney Diseases (2000); 36: 1262 - 1266

4 Zazzo J. et al., Intensive Care Med (1995); 21: 826 - 831

5 Shor R. et al., Annals of Clinical & Laboratory Science (2006); 36: 67 - 72

6 Schwartz A. et al., European Journal of Internal Medicine (2002); 13: 434 - 438

7 Zazzo J. et al., Intensive Care Med (1995); 21: 826 - 831

8 Shor R. et al., Annals of Clinical & Laboratory Science (2006); 36: 67 - 72

9 Schwartz A. et al., European Journal of Internal Medicine (2002); 13: 434 - 438