Calcium mass balance and behavior of intact immunoreactive parathyroid hormone in acetate-free biofiltration: acute and one-year evaluation.
The present study evaluated calcium mass balance (MB) during acetate-free biofiltration (AFB) with a dialysate calcium concentration of 2 mmol/l and different ultrafiltration rates (UF; 42.5 ml/min in schedule 1 and 48.5 ml/min in schedule 3), and with a calcium concentration of 1.75 mmol/l but an UF of 43 ml/min (schedule 2). We also examined the effects of these schedules on the behavior of intact parathyroid hormone (I-PTH). AFB according to schedule 1 and 3 achieve a positive calcium MB (8.49 +/- 1.56 and 5.59 +/- 1.06 mmol, respectively), while in schedule 2 calcium MB merely balanced (0.07 +/- 2.29 mmol/l). A significant acute intradialytic I-PTH decrease was observed with all schedules; after 1 month, however, predialytic PTH values were unchanged in schedules 1 and 3, but worsening was noted in schedule 2. Subsequently, AFB was performed for 12 months employing a dialytic schedule (No. 1) involving a positive calcium balance. A year later I-PTH was significantly lower, thus proving that AFB may play an additional part in controlling secondary hyperparathyroidism.
de Vincenzi
A
A
Servizio di Nefrologia e Dialisi, Ospedale Vigevano, Italia.
Bellazzi
R
R
Santagostino
M
M
Romanini
D
D
Nai
M
M
Gazo
A
A
Bacchella
L
L
Gini
A
A
D000085:Acetates; D000328:Adult; D000368:Aged; D000536:Aluminum Hydroxide / Q000627:therapeutic use; D001639:Bicarbonates / Q000097:blood; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium / Q000008:administration & dosage / Q000097:blood*; D002119:Calcium Carbonate / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D017583:Hemodiafiltration; D015312:Hemodialysis Solutions / Q000494:pharmacology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D006962:Hyperparathyroidism, Secondary / Q000139:chemically induced / Q000517:prevention & control*; D008276:Magnesium Hydroxide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism*; D010758:Phosphorus / Q000097:blood; D012636:Secretory Rate / Q000187:drug effects; D014511:Uremia / Q000097:blood / Q000503:physiopathology / Q000628:therapy
D000085:Acetates; D001639:Bicarbonates; D015312:Hemodialysis Solutions; D010281:Parathyroid Hormone; D010758:Phosphorus; D000536:Aluminum Hydroxide; D002117:Calcitriol; D002119:Calcium Carbonate; D008276:Magnesium Hydroxide; D002118:Calcium