UKidney's Ask the Experts

  1. Prashant
  2. Hemodialysis
  3. Thursday, 02 November 2017
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I'm contemplating using gentamicin and citrate lock for routine usage to lock our dialysis catheters. The problem is that citrate is only available as 46.7% solution. Will it be ok to dilute the citrate in normal saline and add gentamicin to the reconstituted solution? Can we prepare it in batches so that we can use the final solution for a week or at least a day?
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Responses (2)
Hello,

We use 4% citrate locking solutions in dialysis catheters. So in theory, you could dilute down to 4% but doing so obviously requires precision and sterile diluent (possibly sterile water). I am only answering theoretically though as we have seen bad outcomes when making ad-hoc solutions for injection or dialysis purposes.

Dr. Jordan Weinstein
  1. 2 weeks ago
  2. Hemodialysis
  3. # 1
Prashant Accepted Answer
Yes. It's the mixing and more mixing that can be problematic. In the other hand, gentamicin and citrate mixtures are well known to be stable as opposed to gentamicin-heparin mixtures which can lead to precipitation.
  1. 2 weeks ago
  2. Hemodialysis
  3. # 2
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