Nephrological and urological applications

The kidneys regulate the level of fluid and electrolytes in the body and are organs being absolutely essential for life. Depending on the degree of severity, organ failure (kidney failure) can lead to a life-threatening situation.

Electrolytes, which are minerals, are not just excreted in the kidneys, but also recovered. If this complex filtration and resorption mechanism is disrupted, solid deposits (concretions) can form and lead to a painful condition. Moreover, if these concretions grow to a certain size, they can block the ureter. The resulting acute urinary retention can lead to inflammation of the affected kidney (pyelonephritis), inadequate filtration of blood plasma by the kidneys (uremia) and subsequently to symptoms of poisoning. Kidney stones therefore always require medical attention.

The administration of citrates is one approach to the treatment of kidney stones with medication. Citrates are chelating agents that suppress the formation and growth of kidney stones. The citrates react with the stone-forming cations to create metal ion/chelate complexes, which are excreted.

Various sodium, potassium and magnesium citrates, or combinations of these salts, are used in the treatment of kidney stones.

Another application of these mineral salts is the buffering of excess acids during the treatment of distal renal tubular acidosis. With this congenital defect, also known as Butler-Albright-Lightwood syndrome, the kidneys are unable to adequately excrete metabolic acids.

• Magnesium Citrate
• Sodium Citrate
• Sodium Potassium Citrate
• Potassium Citrate
• Magnesium Potassium Citrate

We additionally offer low-endotoxin grades for many of our products.

Hyperphosphatemia can occur if, for example, chronic kidney failure gives rise to an unphysiologically high level of phosphate in the blood plasma. A calcium or vitamin D deficiency, which can lead to bone softening (osteomalacia) if chronic , is another possible cause of high levels of phosphate in the blood. Also hyperparathyroidism (a malfunction of the parathyroid glands) can trigger hyperphosphatemia, because the thyroid and parathyroid glands have a vital regulatory function in bone mineralization.

Calcium deficiency is a frequent outcome of hyperphosphatemia, triggered by the precipitation of calcium phosphate in the tissue.

Organic calcium salts – preferably Calcium Acetate or Calcium Formate – are used to treat hyperphosphatemia. These bind the excess phosphate, which is then excreted. In this way, they can also indirectly suppress the formation of kidney stones, or at least slow the process.

• Calcium Acetate
• Calcium Formate
• Calcium Carbonate
• Calcium Citrate

Hemodialysis

Acute or symptomatic kidney failure and indications such as pulmonary embolism or certain types of poisoning can call for hemodialysis ⁵.

In this renal replacement therapy, which has been in use for around a hundred years, the patient's blood is circulated outside the body (extracorporeally) through a semipermeable membrane, and filtered in the process. Mineral and low-molecular constituents of the blood traverse the membrane and are removed by a cleaning fluid. Large molecules and cells, e.g. thrombocytes, leukocytes and erythrocytes, are retained by the membrane and remain in the blood. In this way, substances that kidneys naturally filter out of the system when in healthy condition are removed from the body, preventing uremia. The blood is cleaned and conveyed back into the body.

During dialysis, it is important to counter the risk of blood clotting as it passes through the dialysis apparatus. For this reason, a Sodium Citrate solution is added to the blood before the filtration process. The citrate combines with calcium ions in the blood to form a chelate compound, to assure that the calcium is no longer present as a coagulation factor. The blood therefore cannot clot, and consequently the dialysis machines remain intact and fully functional.

To ensure the cleaned blood subsequently resumes its normal clotting behavior, calcium is added to it before it returns to the patient's body ⁶.

We offer Sodium Citrate and Calcium Acetate for use in hemodialysis in accordance with different pharmacopoeias and in special low-endotoxin grades.

• Sodium Citrate
• Calcium Citrate
• Calcium Acetate
• Calcium Disodium EDTA

Blood plasma fractionation

Mineral salts are also used in blood treatment and preparation for blood plasma fractionation.

Many of the steps involved in fractionation require the right pH. Being able to set the pH of the plasma very precisely and stably is therefore extremely important during preparation. If, for example, we wish to isolate individual coagulation factors from human blood plasma, the pH can be set using Ammonium Sulfate and Monosodium Phosphate ⁷.

Sodium Acetate is used in the isolation of immunoglobin G, to keep the pH of the filtered plasma within the acid range (pH 5.5) ⁷.

We produce and supply mineral salts for the treatment and further processing of human blood in various pharmaceutical grades and in especially low-endotoxin grades.

• Sodium Acetate
• Ammonium Sulfate
• Monosodium Phosphate