title: Calcium and phosphorus fluxes during hemodialysis with low calcium dialysate.
abstract: We evaluated the acute effects of varying dialysate calcium concentration on plasma concentrations and dialyzer fluxes of calcium and phosphorus in adult hemodialysis patients. Seven individuals with stable end-stage renal failure were dialyzed 4 hours, three times weekly. The effects of dialysates containing 1.75, 1.25, or 0.75 mmol/L (70.1, 50.1, or 30.1 mg/L) of calcium were compared. Each patient was studied once at each bath calcium concentration. Compared with the predialysis mean value of 2.27 mmol/L (9.1 mg/dL), plasma total calcium concentration increased, remained constant, or decreased with the 1.75-, 1.25-, or 0.75-mmol/L calcium dialysates, respectively. The 0.75-mmol/L calcium dialysate did not cause signs or symptoms of hypocalcemia (and the plasma calcium concentration did not fall below 1.80 mmol/L [7.2 mg/dL]). Plasma phosphorus concentrations decreased equally from a predialysis mean value of 2.16 mmol/L (6.7 mg/dL), regardless of the dialysate calcium concentration. After 4 hours of treatment with the three different dialysates, the cumulative calcium fluxes were significantly different. With 1.75 mmol/L calcium, mean bodily calcium accumulation was 21.9 mmol (879 mg). With 1.25 mmol/L, there was no net calcium flux. With 0.75 mmol/L, mean patient calcium loss was 5.8 mmol (231 mg). Mean phosphorus removal after 4 hours was 32.5 mmol (1,006 mg) and was unaffected by dialysate calcium concentration.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Division of Renal Medicine, Michael Reese Hospital and Medical Center, Chicago, IL.
authors.forename: S H
authors.initials: SH
authors.lastname: Hou
authors.forename: J
authors.initials: J
authors.lastname: Zhao
authors.forename: C F
authors.initials: CF
authors.lastname: Ellman
authors.forename: J
authors.initials: J
authors.lastname: Hu
authors.forename: Z
authors.initials: Z
authors.lastname: Griffin
authors.forename: D M
authors.initials: DM
authors.lastname: Spiegel
authors.forename: J E
authors.initials: JE
authors.lastname: Bourdeau
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002118:Calcium / Q000008:administration & dosage / Q000097:blood*; D015314:Dialysis Solutions; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis
chemical_list: D015314:Dialysis Solutions; D010710:Phosphates; D002118:Calcium