Evolution of serum phosphate in long intermittent hemodialysis.
BACKGROUND
Phosphate (P) control is crucial to prevent secondary hyperparathyroidism and extraosseous calcification. Hemodialysis techniques normally used do not remove the amount of P absorbed from an adequate protein intake. Our long hemodialysis (LHD) procedure produces greater P removal in a seven-hour session than in a conventional four-hour session. Our aim was to assess the evolution of predialysis serum P and Ca x P product in patients on intermittent LHD during the first two years on this dialysis schedule.


METHODS
Eight irregular compliant patients underwent LHD for 12 months; five of them completing 24 months. In the conventional hemodialysis (CHD) period, session time was 12 hours per week, while it was 21 hours per week in LHD. We compared P and Ca x P product throughout both periods; each patient was his or her own control.


RESULTS
Mean serum P improved from 7.1 +/- 1.1 mg/dL in CHD to 5.6 +/- 1.1 mg/dL during the second year on LHD (P < 0.05). Mean Ca x P product decreased from 64 +/- 12.7 mg2/dL2 during CHD to 50.9 +/- 10.3 mg2/dL2 at the end of the second year of LHD.


CONCLUSIONS
By prolonging dialysis time to 21 hours per week, better P serum control and lower Ca x P product were achieved in our patients.
Fajardo
Laura
L
Centro de Dialisis Uruguayana, Montevideo, Uruguay.
Campistrús
Nieves
N
Ríos
Pablo
P
Gómez
Teresa
T
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors
D010281:Parathyroid Hormone; D010710:Phosphates; D000469:Alkaline Phosphatase; D002118:Calcium