title: Changes of serum calcium, magnesium and parathyroid hormone induced by hemodialysis with citrate-enriched dialysis solution.
abstract: OBJECTIVE
  In recent years, one of technical attempts to improve biocompatibility and tolerability of the hemodialysis procedure is the substitution of acetate in dialysis solution with citrate. The aim of our study was to compare two dialysis solutions: traditional bicarbonate dialysis solution containing acetate (3 mmol/L) (solution A); and (solution C) commercially produced citrate-enriched bicarbonate dialysis solution (0.8 mmol/L citrate).
  
  
  METHODS
  Patients from a single hemodialysis center (N=126) were included in the study. Both conventional low-flux hemodialysis and on-line hemodiafiltration procedures were studied. Both dialysis solutions contained identical calcium (1.5 mmol/L) and magnesium (0.5 mmol/L) concentrations.
  
  
  RESULTS
  Parathyroid hormone (iPTH) concentration decreased during procedures with solution A by 64%. On the contrary, when solution C was used, iPTH concentration increased insignificantly by 4%. For solution A, serum calcium and magnesium increased during procedures in patients with predialysis concentrations lower than 2.33 and 0.76 mmol/L, respectively. In procedures with dialysis solution C these concentrations were significantly lower: 2.19 mmol/L for Ca and 0.68 mmol/L for Mg.
  
  
  CONCLUSIONS
  Our study clearly shows that the substitution of part of acetate with citrate in dialysis solution significantly influences changes of serum calcium, magnesium and parathyroid hormone concentrations during hemodialysis and hemodiafiltration procedures.
authors: Hemodialysis Center, University Hospital, Hradec Kralove, Czech Republic.
authors: Roman
authors: R
authors: Šafránek
authors: Petr
authors: P
authors: Moučka
authors: Jaroslava
authors: J
authors: Vávrová
authors: Vladimír
authors: V
authors: Palička
authors: Ladislava
authors: L
authors: Pavlíková
authors: Sylvie Dusilová
authors: SD
authors: Sulková
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D019343:Citric Acid / Q000008:administration & dosage*; D015331:Cohort Studies; D015314:Dialysis Solutions / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000639:trends*
chemical_list: D015415:Biomarkers; D015314:Dialysis Solutions; D010281:Parathyroid Hormone; D019343:Citric Acid; D008274:Magnesium; D002118:Calcium