Short- and Long-term Effects of Dialysate Calcium Concentrations on Mineral and Bone Metabolism in Hemodialysis Patients: The K4 Study

被引：7

作者：

Sakoh, Teppei ^{[1
]}

Taniguchi, Masatomo ^{[2
]}

Yamada, Shunsuke ^{[3
]}

Ohnaka, Shotaro ^{[4
]}

Arase, Hokuto ^{[3
]}

Tokumoto, Masanori ^{[5
]}

Yanagida, Taihei ^{[4
]}

Mitsuiki, Koji ^{[1
]}

Hirakata, Hideki ^{[1
,2
]}

Nakano, Toshiaki ^{[3
]}

Kitazono, Takanari ^{[3
]}

Tsuruya, Kazuhiko ^{[3
,6
,7
]}

机构：

[1] Japanese Red Cross Fukuoka Hosp, Div Nephrol, Fukuoka, Japan

[2] Fukuoka Renal Clin, Fukuoka, Japan

[3] Kyushu Univ, Grad Sch Med Sci, Dept Med & Clin Sci, Fukuoka, Japan

[4] Steel Mem Yawata Hosp, Div Nephrol, Fukuoka, Japan

[5] Fukuoka Dent Coll, Dept Internal Med, Fukuoka, Japan

[6] Kyushu Univ, Grad Sch Med Sci, Dept Integrated Therapy Chron Kidney Dis, Fukuoka, Japan

[7] Nara Med Univ, Dept Nephrol, Nara, Japan

来源：

KIDNEY MEDICINE | 2019年 / 1卷 / 05期

关键词：

Calcium; dialysate calcium concentration; hemodialysis; parathyroid hormone;

D O I：

10.1016/j.xkme.2019.08.002

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Rationale & Objective: The short- and long-term impact of conversion of dialysate calcium concentration from either 2.5 or 3.0 mEq/L to 2.75 mEq/L on mineral and bone metabolism remains unknown in hemodialysis patients. Study Design: Nonrandomized intervention study. Setting & Population: 12 hemodialysis patients treated at baseline with a 2.5-mEq/L dialysate calcium concentration and another 12 hemodialysis patients treated with a 3.0-mEq/L dialysate calcium concentration. Intervention: Use of 2.75-mEq/L dialysate calcium concentration. Outcomes: Changes in intradialytic calcium and phosphate clearance and changes in predialysis and intradialytic serum and ionized mineral and biochemical parameters over the 24 weeks following dialysate calcium conversion. Results: Conversion of dialysate calcium concentration from 2.5 to 2.75 mEq/L increased intradialytic calcium loading and serum total and ionized calcium levels, whereas conversion of dialysate calcium from 3.0 to 2.75 mEq/L decreased intradialytic calcium loading and serum total and ionized calcium levels. Dialysate calcium concentration conversion did not affect intradialytic serum parathyroid hormone level, intradialytic phosphate elimination, or predialysis serum calcium, phosphate, parathyroid hormone, and fibroblast growth factor 23 levels. Intradialytic calcium influx was determined by dialysate calcium concentration and predialysis serum calcium levels, whereas intradialytic phosphate elimination was determined by predialysis serum phosphate levels. Limitations: Small sample size and no control groups treated with 2.5- and 3.0-mEq/L dialysate calcium concentrations during the 24 weeks of the observation period. Conclusions: Conversion of dialysate calcium concentration from either 3.0 or 2.5 to 2.75 mEq/L results in expected changes in calcium loading based on predialysis calcium concentration. The dialysate calcium concentration should be personalized based on clinical factors.

引用

页码：296 / 306

页数：11

共 48 条

[1] Long-Term Effect of Different Dialysate Calcium Concentrations on Parathyroid Hormone Levels in Hemodialysis Patients
Hwang, Jyh-Chang
Chen, Chien-An
Wang, Charn-Ting
Chen, Hung-Chun
RENAL FAILURE, 2008, 30 (10) : 943 - 951
[2] Effects of Lowering Dialysate Calcium Concentration on Mineral Metabolism and Hemodynamic Parameters in Hemodialysis Patients
Alayoud, Ahmed
El Kabbaj, Driss
Benyahia, Mohammed
Asseraji, Mohammed
Zemraoui, Nadir
IRANIAN JOURNAL OF KIDNEY DISEASES, 2015, 9 (02) : 132 - 137
[3] Short- and long-term effects of calcium and exercise on bone mineral density in ovariectomized rats
Gala, J
Díaz-Curiel, M
de la Piedra, C
Calero, J
BRITISH JOURNAL OF NUTRITION, 2001, 86 (04) : 521 - 527
[4] Short and long-term effects of kidney donation on mineral and bone metabolism
Duque, Eduardo Jorge
Ferreira, Gustavo Fernandes
Oliveira, Ivone Braga
Dominguez, Wagner
Agena, Fabiana
Jorgetti, Vanda
Lemos, Francine
Wolf, Myles
David-Neto, Elias
Moyses, Rosa Maria A.
BMC NEPHROLOGY, 2024, 25 (01)
[5] Personalized Prediction of Short- and Long-Term PTH Changes in Maintenance Hemodialysis Patients
Pirklbauer, Markus
Bushinsky, David A.
Kotanko, Peter
Schappacher-Tilp, Gudrun
FRONTIERS IN MEDICINE, 2021, 8
[6] Short- and long-term uses of calcium acetate do not change hair and serum zinc concentrations in hemodialysis patients
Hwang, SJ
Chang, JM
Lee, SC
Tsai, JH
Lai, YH
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION, 1999, 59 (02) : 83 - 87
[7] Short- and long-term outcomes of pancreatectomy in patients with hemodialysis
Teraoku, Hiroki
Morine, Yuji
Ikemoto, Tetsuya
Saito, Yu
Yamada, Shinichiro
Okikawa, Shohei
Miyazaki, Katsuki
Shimada, Mitsuo
JOURNAL OF MEDICAL INVESTIGATION, 2023, 70 (1-2) : 105 - 109
[8] Effects of reduced dialysate calcium on calcium-phosphorus product and bone metabolism in Hemodialysis patients
Fiedler, R
Deuber, HJ
Langer, T
Osten, B
Mohan, S
Jehle, PM
NEPHRON CLINICAL PRACTICE, 2004, 96 (01): : C3 - C9
[9] Long term effects on mineral and bone metabolism by low versus standard calcium dialysate in peritoneal dialysis: a meta-analysis
Cao, Xue-Ying
Zhou, Jian-Hui
Cai, Guang-Yan
Ding, Rui
Tang, Li
Wu, Di
Wei, Ri-Bao
Chen, Xiang-Mei
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, 2015, 8 (02): : 2031 - 2037
[10] Simultaneous conversion of dialysate magnesium concentration from 1.0 to 1.2 mEq/L and dialysate calcium concentration from 3.0 to 2.6 mEq/L and changes in serum mineral and bone metabolism markers in patients undergoing maintenance hemodialysis: a retrospective study
Yamada, Shunsuke
Matsueda, Shumei
Arase, Hokuto
Yamada, Kanako
Nishida, Hiroshi
Nakano, Toshiaki
RENAL REPLACEMENT THERAPY, 2024, 10 (01)

← 1 2 3 4 5 →