title: Dialysate Calcium Concentration, Mineral Metabolism Disorders, and Cardiovascular Disease: Deciding the Hemodialysis Bath.
abstract: Patients with end-stage kidney disease treated with dialysis are at increased risk to experience fractures and cardiovascular events than similar-aged people from the general population. The enhanced risk for these outcomes in dialysis patients is not completely explained by traditional risk factors for osteoporosis and cardiovascular disease. Mineral metabolism abnormalities are almost universal by the time patients require dialysis therapy, with most patients having some type of renal osteodystrophy and vascular calcification. These abnormalities have been linked to adverse skeletal and cardiovascular events. However, it has become clear that the treatment regimens used to modify the serum calcium, phosphate, and parathyroid hormone levels almost certainly contribute to the poor outcomes for dialysis patients. In this article, we focus on one aspect of mineral metabolism management; dialysate calcium concentration and the relationships among dialysate calcium concentrations, mineral and bone disorder, and cardiovascular disease in hemodialysis patients.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Amit
authors.initials: A
authors.lastname: Langote
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Micayla
authors.initials: M
authors.lastname: Ahearn
authors.affiliation: Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa Hospital, Ottawa, Ontario, Canada; Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: dzimmerman@ottawahospital.on.ca.
authors.forename: Deborah
authors.initials: D
authors.lastname: Zimmerman
mesh_terms: D001851:Bone Diseases, Metabolic / Q000150:complications / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000150:complications / Q000378:metabolism*; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry*; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D006435:Renal Dialysis / Q000379:methods*; D061205:Vascular Calcification / Q000150:complications / Q000378:metabolism
chemical_list: D015312:Hemodialysis Solutions; D010281:Parathyroid Hormone; D002118:Calcium
keywords: Dialysate calcium; calcific uremic arteriolopathy; cardiovascular; mineral metabolism; review; sudden cardiac death