title: Haemodialysis session: the perfect storm for vascular calcification.
abstract: BACKGROUND
  Vascular calcification (VC) associated to chronic kidney disease (CKD) is a complex phenomenon closely related to mineral bone metabolism disorders. Many are the factors implicated, as the drugs used in the treatment of CKD. Some in vitro studies suggest that electrolyte and acid-base disorders induced by hemodialysis (HD) may play a key role in VC.
  
  
  METHODS
  We analyzed electrolyte and acid-base disorders that occur during an HD session in 26 patients randomly assigned to 1,25 mM or 1,5 mM calcium bath.
  
  
  RESULTS
  There is a calcium load in all the patients, independently of calcium bath concentration or basal serum calcium levels. At the end of the session, 100% of the patients dialyzed with 1,5 mM calcium bath have calcium serum levels > 1,3 mM. However, this only occurs in 15% of the patients dialysed with 1,25 mM calcium bath. During this calcium load, phosphorus levels persist uncontrolled. Besides, there is a progressive alkalinization in all the patients. In the end of the session 50% have serum bicarbonate > 30 mM and 23% pH > 7,5.
  
  
  CONCLUSIONS
  During HD sessions occur electrolyte and acid-base disorders that induce VC: Calcium load and alkalization in presence of elevated phosphorus levels. It is necessary to perform studies with kinetic models of calcium load and alkalinization different from the actual ones.
authors: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Miguel
authors: M
authors: Seras
authors: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: angelmartindefrancisco@gmail.com.
authors: Ángel Luis
authors: ÁL
authors: Martín de Francisco
authors: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Celestino
authors: C
authors: Piñera
authors: Servicio de Análisis Clínicos, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Simón
authors: S
authors: Gundin
authors: Servicio de Análisis Clínicos, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Marta
authors: M
authors: García-Unzueta
authors: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Maria
authors: M
authors: Kislikova
authors: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Zoila
authors: Z
authors: Albines
authors: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Mara
authors: M
authors: Serrano
authors: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors: Manuel
authors: M
authors: Arias
mesh_terms: D000137:Acid-Base Imbalance / Q000097:blood / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D001639:Bicarbonates / Q000097:blood; D002118:Calcium / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000150:complications; D005260:Female; D015312:Hemodialysis Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008274:Magnesium / Q000097:blood; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy; D061205:Vascular Calcification / Q000097:blood / Q000209:etiology* / Q000503:physiopathology
chemical_list: D001639:Bicarbonates; D015312:Hemodialysis Solutions; D010281:Parathyroid Hormone; D010758:Phosphorus; D008274:Magnesium; D002118:Calcium
keywords: Calcificación vascular; Chronic kidney disease; Enfermedad renal crónica; Hemodialysis; Hemodiálisis; Vascular calcification