Effect of Different Calcium Dialysate Concentrations on Parathyroid Hormone in Chronic Hemodialysis Patients
Hayfaa Ibrahim Mohamed;
Abstract
Hemodynamic stability, Renal bone disease, vascular and valvular calcification are main issues regarding the role of calcium in hemodialysis patients so the choice of dialysate calcium concentration is able to influence many of the most important factors in the successful management of chronic HD patients. (Christopher, 2008)
In current practice, little attention is paid to the dialysate calcium concentration, On the contrary, it should be viewed as part of the integrated therapeutic regimen to control renal osteodystrophy and maintain normal mineral metabolism. (Nouri et al., 2008)
The goals are to keep the patient in a mild positive Ca mass balance, to maintain normal serum Ca levels, to control plasma parathyroid hormone (PTH) values from two to three times above normal levels, and to avoid soft-tissue calcifications.
Accordingly, the present study was designed to investigate the relative effect of two Dialysate Calcium Concentrations 1.5mmol/l and 1.75mmol/l on Parathyroid Hormone Levels and hemodynamic stability parameters in ESRD patients on regular hemodialysis.
The study was conducted on 25 chronic renal failure patients on regular haemodialysis with dialysate Ca concentration 1.75mmol/l for at least than 6 months then shifted to Ca dialysate 1.5mmol/l for two months.
Regarding the 25 patients 17 of them were males (68%) and 8 of them were females (32%) with mean of age was 54.56±11.64 years, mean of BMI was 47.45±1.21, mean of dialysis duration was 6.57±3.63 years, mean of dry weight was 79.32±19.71 Kg, mean of UF volume was 3.4±0.8 liter, mean systolic BP was 123.6±15.8mmHg and mean diastolic BP was75.6±8.7mmHg.
Regarding Calcium supplement 16 of the patients on Calcium acetate (64%), 4 of them on Calcium carbonate (16%) and 5 of them not receiving (20%) with mean of Calcium supplement dose 2370 ±877 mg/day and mean of vit D dose 2.75±0.44 ug/wk.
All patients were subjected to clinical examination and clinical monitoring regarding blood pressure , rate and rhythm of pulse during hemodialysis session and were subjected to kidney function tests, urea reduction ratio, complete blood count, ionized calcium, total serum calcium, serum phosphorus, serum albumin, serum alkaline phosphatase, serum parathormone level, ECG before and after shifting to lower Calcium dialysate for assessment of heart rate, QT interval and change of rate and rhythm of pulse and transthoracic echocardiography for assessment of EF, LV diastolic dysfunction, LVH and valvular calcification.
In current practice, little attention is paid to the dialysate calcium concentration, On the contrary, it should be viewed as part of the integrated therapeutic regimen to control renal osteodystrophy and maintain normal mineral metabolism. (Nouri et al., 2008)
The goals are to keep the patient in a mild positive Ca mass balance, to maintain normal serum Ca levels, to control plasma parathyroid hormone (PTH) values from two to three times above normal levels, and to avoid soft-tissue calcifications.
Accordingly, the present study was designed to investigate the relative effect of two Dialysate Calcium Concentrations 1.5mmol/l and 1.75mmol/l on Parathyroid Hormone Levels and hemodynamic stability parameters in ESRD patients on regular hemodialysis.
The study was conducted on 25 chronic renal failure patients on regular haemodialysis with dialysate Ca concentration 1.75mmol/l for at least than 6 months then shifted to Ca dialysate 1.5mmol/l for two months.
Regarding the 25 patients 17 of them were males (68%) and 8 of them were females (32%) with mean of age was 54.56±11.64 years, mean of BMI was 47.45±1.21, mean of dialysis duration was 6.57±3.63 years, mean of dry weight was 79.32±19.71 Kg, mean of UF volume was 3.4±0.8 liter, mean systolic BP was 123.6±15.8mmHg and mean diastolic BP was75.6±8.7mmHg.
Regarding Calcium supplement 16 of the patients on Calcium acetate (64%), 4 of them on Calcium carbonate (16%) and 5 of them not receiving (20%) with mean of Calcium supplement dose 2370 ±877 mg/day and mean of vit D dose 2.75±0.44 ug/wk.
All patients were subjected to clinical examination and clinical monitoring regarding blood pressure , rate and rhythm of pulse during hemodialysis session and were subjected to kidney function tests, urea reduction ratio, complete blood count, ionized calcium, total serum calcium, serum phosphorus, serum albumin, serum alkaline phosphatase, serum parathormone level, ECG before and after shifting to lower Calcium dialysate for assessment of heart rate, QT interval and change of rate and rhythm of pulse and transthoracic echocardiography for assessment of EF, LV diastolic dysfunction, LVH and valvular calcification.
Other data
| Title | Effect of Different Calcium Dialysate Concentrations on Parathyroid Hormone in Chronic Hemodialysis Patients | Other Titles | تاثير التركيزات المختلفه للكالسيوم فى محلول الديلزه على هرمون الغده الجار درقيه فى مرضى الاستصفاء الدموى المزمن | Authors | Hayfaa Ibrahim Mohamed | Issue Date | 2016 |
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