- Hypocalcaemia – due to chelation
- Hypomagnesaemia – Mg2+ is also chelated
- Hypernatraemia – high sodium load in hyperosmolar trisodium citrate
- Metabolic alkalosis – citrate is metabolised to bicarbonate
- Metabolic acidosis (RAGMA) – caused by the citrate accumulation if there is impaired metabolism (e.g. liver failure)