Acute effects of different concentrations of dialysate magnesium during high-efficiency dialysis
| Autor: | James A. Delmez, Eduardo Slatopolsky, Jacobo Kelber |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Acute effects
medicine.medical_specialty Time Factors medicine.medical_treatment chemistry.chemical_element Administration Oral Dialysis patients Renal Dialysis Internal medicine Dialysis Solutions medicine Humans Magnesium Dialysis Analysis of Variance Dialysis fluid business.industry Phosphorus Endocrinology Biochemistry chemistry Nephrology Linear Models Female Kidney Diseases Hemodialysis medicine.symptom business Muscle cramp |
| Zdroj: | American journal of kidney diseases : the official journal of the National Kidney Foundation. 24(3) |
| ISSN: | 0272-6386 |
| Popis: | It has been suggested that magnesium carbonate (MgCO 3 ) may be an effective and safe alternative to calcium carbonate in binding phosphorus in dialysis patients. In these studies, the concentration of magnesium in the dialysate was either very low or zero. To date, only patients undergoing conventional dialysis have been reported. The primary purpose of the present study was to determine the fluxes of magnesium using dialysate magnesium concentrations of 0 mg/dL, 0.6 mg/dl, and 1.8 mg/dL in eight patients undergoing high-efficiency hemodialysis. The net removal of magnesium was 486 ± 44 mg, 306 ± 69 mg, and 56 ± 50 mg, with the use of dialysate magnesium concentrations of 0 mg/dL, 0.6 mg/dL, and 1.8 mg/dL, respectively ( P = 0.001). Plasma magnesium levels significantly decreased from 3.3 ± 0.2 mg/dL to 1.6 ± 0.2 mg/dL and from 3.4 ± 0.3 mg/dL to 2.1 ± 0.2 mg/dL during the dialysis sessions using 0 mg/dL and 0.6 mg/dL magnesium dialysates, respectively. Plasma magnesium remained unchanged when 1.8 mg/dL dialysate magnesium was used. A significant independent correlation was found between the total magnesium removed and both the dialysate concentration used ( P P 3 was added to the regimen. Eight of the 15 patients could not tolerate the no-magnesium dialysate due to severe muscle cramps. The cramps were unrelated to changes in - blood pressure and were immediately relieved by switching the magnesium in the dialysate to 1.8 mg/dL. The patients then underwent a further 2-week trial of dialysis using a dialysate magnesium of 0.6 mg/dL. This formulation was well tolerated by all patients. In this acute study, we conclude that high-efficiency dialysis with a magnesium-free dialysate is associated with a high incidence of muscle cramps. Magnesium removal using a dialysate magnesium concentration of 0.6 mg/dL is considerable, yet well tolerated when used in combination with MgCO 3 as a phosphorus binder. |
| Databáze: | OpenAIRE |
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