Calcium free hemodialysis: experience in the treatment of 33 patients with severe hypercalcemia.
OBJECTIVE
To assess the efficacy, adverse effects and relevance of calcium-free hemodialysis (CFHD) in the treatment of major hypercalcemia.


METHODS
Retrospective chart review.


METHODS
Medical ICU.


METHODS
All patients admitted over a 9-year period for hypercalcemia requiring urgent treatment and who underwent hemodialysis.


METHODS
CFHD with an acetate dialysate.


RESULTS
Thirty-three patients with severe hypercalcemia from various etiologies received CFHD. Marked and rapid decrease of serum total calcium was obtained during all sessions (mean decrease: 1.71 +/- 0.54 mmol/l). Calcium rebound within 24 h after CFHD was observed in all evaluable cases (1 +/- 0.45 mmol/l; mean delay 13.7 +/- 5.8 h). Adverse cardiovascular effects occurred in 17 of 48 sessions (35%) and in 13 of 30 evaluable patients (43%).


CONCLUSIONS
Adverse effects are frequent during CFHD. After correction of hypovolemia, its use should be restricted to patients with severe clinical symptoms or advanced renal impairment.
Camus
C
C
Service de Reanimation Medicale, Hopital Pontchaillou, Rennes, France.
Charasse
C
C
Jouannic-Montier
I
I
Seguin
P
P
Tulzo
Y L
YL
Bouget
J
J
Thomas
R
R
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002118:Calcium / Q000097:blood; D015314:Dialysis Solutions / Q000627:therapeutic use*; D004630:Emergencies; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
D015314:Dialysis Solutions; D002118:Calcium