Effects of low dialysate calcium concentration on health-related quality of life in hemodialysis patients.
BACKGROUND
A dialysate calcium concentration of 2.5 meq/l (1.25 mmol/l) is currently recommended, but there are not enough studies to examine the effects of this calcium concentration on clinical outcomes. We explored the effects of this calcium concentration on health-related quality of life (HRQOL) in hemodialysis patients.


METHODS
The dialysate calcium concentration was lowered from 3.0 meq/l to 2.5 meq/l in 78 hemodialysis patients. The Medical Outcomes Study (MOS) Short Form 36 (SF-36) norm-based scores, the doses of recombinant human erythropoietin (rHuEpo), and the serum levels of corrected calcium, phosphorus, intact parathyroid hormone (i-PTH), and hemoglobin were compared at baseline and 8 months after the change of dialysate calcium concentration.


RESULTS
Seventy-three patients completed the study. Mean changes in SF-36 scores were: physical functioning, -2.4; role physical, -3.9; bodily pain, -3.4; general health perception, -1.5; vitality, -2.2; social functioning, -1.9; role emotional, -2.0; mental health, -2.0. The declines of scores for role physical and bodily pain were significant. Serum i-PTH levels increased significantly, from 212 pg/ml to 278 pg/ml, while the doses of rHuEpo and serum levels of corrected calcium, phosphorus, and hemoglobin did not change significantly.


CONCLUSIONS
A dialysate calcium concentration of 2.5 meq/l was not shown to have positive effects on HRQOL.
Department of Nephrology, Saiseikai Nakatsu Hospital, Osaka, Japan. ytaji@kuhp.kyoto-u.ac.jp
Yoshinori
Y
Taji
Takeshi
T
Morimoto
Shunichi
S
Fukuhara
Tsuguya
T
Fukui
Takashi
T
Kuwahara
D000368:Aged; D002118:Calcium / Q000008:administration & dosage*; D005260:Female; D015312:Hemodialysis Solutions / Q000008:administration & dosage* / Q000737:chemistry; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D015312:Hemodialysis Solutions; D002118:Calcium