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Changes in Serum Electrolytes during Treatment of Patients in Liver Failure with Molecular Adsorbent Recirculating System

Purpose To study the effect of MARS on serum electrolytes during liver failure. Design Twenty-three patients admitted to a quaternary health care facility from September 2000 to May 2002, 22 adults and 1 child, 11 males (48%) and 12 females (52%), age 15–70 (median 53), treated with MARS for: 12 acute-on-chronic liver failure (52%); 4 fulminant hepatic failure (17%); 3 intractable pruritus (13%); 2 primary-non-function (9%); 2 following major liver resection (9%). Procedures Sodium, potassium, chloride, phosphorus, calcium, and magnesium were measured in the serum, ultrafiltrate and albumin circuit before and after MARS. Statistical methods A comparison of electrolyte concentrations, before and after MARS, was performed using a paired t test. Main findings Serum electrolyte concentrations before and after MARS, while statistically significant in some cases, were very small, and of no clinical relevance. Conclusion MARS exchanges potassium, chloride, calcium, and magnesium by ultrafiltration; sodium by the albumin dialysis.