Effects of bone remodelling on calcium mass transfer during haemodialysis.

Autor:	Karohl C; Nephrology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil., de Paiva Paschoal J, de Castro MC, Elias RM, Abensur H, Romão JE Jr, Passlick-Deetjen J, Jorgetti V, Moysés RM
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2010 Apr; Vol. 25 (4), pp. 1244-51. Date of Electronic Publication: 2010 Jan 29.
DOI:	10.1093/ndt/gfp597
Abstrakt:	Background: During haemodialysis, calcium balance can affect, or be affected by, mineral metabolism. However, when dialysate calcium concentration (d[Ca]) is chosen or kinetic models are employed to calculate calcium balance, bone remodelling is rarely considered. In this study, we examined whether bone remodelling affects calcium mass transfer during haemodialysis. Methods: We dialysed 23 patients using a d[Ca] of 1.0, 1.25, 1.5 or 1.75 mmol/L. Calcium mass transfer was measured and associated with remodelling bone factors. Results: Calcium balance varied widely depending on the d[Ca]. Calcium removal was -578 +/- 389, -468 +/- 563, +46 +/- 400 and +405 +/- 413 mg when a d[Ca] of 1.0, 1.25, 1.5 or 1.75 mmol/L was used, respectively (1.0 and 1.25 vs 1.5 and 1.75 mmol/L, P < 0.001; 1.5 vs 1.75 mmol/L, P < 0.05). Univariate analysis showed that calcium balance correlated with calcium gradient, parathyroid hormone (PTH), osteocalcin and dialysis vintage. Multivariate analysis revealed that calcium balance was dependent on calcium gradient, PTH and osteocalcin. Conclusions: These results suggest that bone remodelling could affect calcium mass transfer during haemodialysis.
Databáze:	MEDLINE
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