Calcium mass balances during standard bicarbonate hemodialysis and long-hour slow-flow bicarbonate hemodialysis
| Autor: | Annalisa Teutonico, Carlo Lomonte, Francesco Casucci, Pasquale Maselli, Pasquale Libutti, Luigi Vernaglione, Anna Lucia Di Turo, Sergio Tundo, Nicola Losurdo, Carlo Basile |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Bicarbonate medicine.medical_treatment Parathyroid hormone Hemodialysis Solutions chemistry.chemical_compound Renal Dialysis Internal medicine medicine Humans Renal osteodystrophy Renal Insufficiency Dialysis Aged Chronic Kidney Disease-Mineral and Bone Disorder Calcium metabolism Cross-Over Studies business.industry Hydrogen-Ion Concentration Middle Aged medicine.disease Crossover study Bicarbonates Treatment Outcome Endocrinology chemistry Parathyroid Hormone Nephrology Calcium Female Hemodialysis business |
| Zdroj: | Journal of Nephrology. 24:742-748 |
| ISSN: | 1121-8428 |
| DOI: | 10.5301/jn.2011.6385 |
| Popis: | BACKGROUND Dialysate calcium (Ca) concentration should be viewed as part of the integrated therapeutic regimen to control renal osteodystrophy and maintain normal mineral metabolism. Thus, a correct ionized calcium mass balance (Ca++MB) during hemodialysis (HD) is crucial in the treatment of renal osteodystrophy. The GENIUS single-pass batch dialysis system (Fresenius Medical Care, Germany) consists of a closed dialysate tank of 90 L; it offers the opportunity of effecting mass balances of any solute in a very precise way. METHODS The present study has a crossover design: 11 stable anuric HD patients underwent 2 bicarbonate HD sessions, 1 of 4 hours (4h) and the other of 8 hours (8h) in a random sequence, always at the same interdialytic interval, at least 1 week apart. The GENIUS system and high-flux FX80 dialyzers (Fresenius Medical Care, Germany) were used. The volume of blood and dialysate processed, volume of ultrafiltration and dialysate Ca concentrations (1.50 mmol/L) were prescribed to be the same. Trends of plasma Ca++, blood pH and bicarbonates during dialysis, as well as Ca++MBs were determined. Plasma parathyroid hormone (PTH) levels at the start and end of the 2 treatments were measured. RESULTS Ca++MBs (mean ± SD) were +284.6 ± 137.4 mg and +297.7 ± 131.6 mg (p=0.307) in the 4h and 8h treatments, respectively. No single session out of the 22 had a negative Ca++MB for the patient. Mean plasma Ca++, blood pH and bicarbonate levels were not statistically significantly different when comparing the start and end of the sessions of the 2 treatments. Mean plasma Ca++, blood pH and bicarbonate levels increased significantly along the time points in both 4h and 8h HD sessions (repeated measures ANOVA: p |
| Databáze: | OpenAIRE |
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