Optimizing the dialysate calcium concentration in bicarbonate haemodialysis

Nephrology Dialysis Transplantation

Volumn 27, Issue 6, 2012, Pages 2489-2496

  Bosticardo, Gianmario ^a   Malberti, Fabio ^b   Basile, Carlo ^c   Leardini, Loretta ^a   Libutti, Pasquale ^c   Filiberti, Oliviero ^d   Schillaci, Enrico ^a   Ravani, Pietro ^e  

^a OSPEDALE DEGLI INFERMI   (Italy)

^b CREMONA HOSPITAL   (Italy)

^c MIULLI GENERAL HOSPITAL   (Italy)

^d SANT'ANDREA HOSPITAL   (Italy)

^e UNIVERSITY OF CALGARY   (Canada)

Author keywords

Calcium mass balance; CKD MBD; Dialysate calcium; Gibbs Donnan factor; Ionized calcium

Indexed keywords

BICARBONATE; CALCIUM;

ADULT; ARTICLE; CALCIUM BLOOD LEVEL; CALCIUM MASS BALANCE; CALCIUM TRANSPORT; CLINICAL ARTICLE; DIALYSATE CALCIUM CONCENTRATION; DIALYSATE LEVEL; FEMALE; HEMODIALYSIS; HEMODIALYSIS PATIENT; HUMAN; MALE; PRIORITY JOURNAL; ULTRAFILTRATION;

BICARBONATES; CALCIUM; FEMALE; HEMODIALYSIS SOLUTIONS; HUMANS; KIDNEY FAILURE, CHRONIC; MALE; MIDDLE AGED; PROGNOSIS; RENAL DIALYSIS;

EID: 84861899180     PISSN: 09310509     EISSN: 14602385     Source Type: Journal    
DOI: 10.1093/ndt/gfr733     Document Type: Article

References (32)

1. Block GA, Klassen PS, Lazarus JM et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol 2004; 15: 2208-2218
2. London GM, Guerin AP, Marchais F et al. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 2003; 18: 1731-1740
3. Young EW, Albert JM, Satayathum S et al. Predictors and consequences of altered mineral metabolism: the Dialysis Outcomes and Practice Patterns Study. Kidney Int 2005; 67: 1179-1187
4. Cozzolino M, Brancaccio D, GallieniM et al. Pathogenesis of vascular calcification in chronic kidney disease. Kidney Int 2005; 68: 429-436
5. Goodman WG, Goldin J, Kuizon BD et al. Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 2000; 342: 1478-1483
6. Goodman WG, London G, Amann K et al. Vascular calcification in chronic kidney disease. Am J Kidney Dis 2004; 43: 572-579
7. Giachelli CM. Vascular calcification mechanisms. J Am Soc Nephrol 2004; 15: 2959-2964
8. Yang H, Curinga G, Giachelli CM. Elevated extracellular calcium levels induce smooth muscle cell matrix mineralization in vitro. Kidney Int 2004; 66: 2467-2468
9. Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int 2009; 113: S1-S130
10. Hsu HC. Are we mismanaging calcium and phosphate metabolism in renal failure? Am J Kidney Dis 1997; 29: 641-649
11. Gotch F, Kotanko P, Handelman G et al. A kinetic model of calcium mass balance during dialysis therapy. Blood Purif 2007; 25: 139-149
12. Gotch FA. Pro/Con debate: the calculation on calcium balance in dialysis lowers the dialysate calcium concentration (pro part). Nephrol Dial Transplant 2009; 24: 2994-2996
13. Gotch FA, Levin N, Kotanko P. Calcium balance in dialysis is best managed by adjusting dialysate calcium guided by kinetic modeling of the interrelationship between calcium intake, dose of vitamin D analogues and the dialysate calcium concentration. Blood Purif 2010; 29: 163-176
14. Drüeke T, TouamM. Calcium balance in haemodialysis-do not lower the dialysate calcium concentration too much (con part). Nephrol Dial Transplant 2009; 24: 2990-2993
15. Malberti F, Ravani P. The choice of the dialysate calcium concentration in the management of patients in hemodialysis and hemodiafiltration. Nephrol Dial Transplant 2003; 18 (Suppl 7): 37-40
16. Genovesi S, Dossi C, Viganò Met al. Electrolyte concentration during haemodialysis and QT interval prolongation in uremic patients. Europace 2008; 10: 771-776
17. Argilés A, Mion CM. Low-calcium dialysate worsens secondary hyperparathyroidism. J Am soc Nephrol 1996; 7: 635-636
18. Moe SM. Confusion on the complexity of calcium balance. Semin Dial 2010; 23: 492-497
19. Basile C, Libutti P, Lomonte C. The diffusion gradient between the ionized calcium concentration in the dialysate and in the blood is the main driving force of the net calcium mass balance during haemodialysis. Nephrol Dial Transplant 2010; 25: 1356-1357
20. Fabrizi F, Bacchini G, Di Filippo S et al. Intradialytic calcium balances with different calcium dialysate levels. Effects on cardiovascular stability and parathyroid function. Nephron 1996; 72: 530-535
21. Sigrist M, McIntyre CW. Calcium exposure and removal in chronic hemodialysis patients. J Ren Nutr 2006; 6: 41-46
22. Bosticardo GM. The diffusion gradient between the ionized calcium concentration in the dialysate and plasma water-corrected for Gibbs-Donnan factor-is themain driving force of the net calciummass balance during haemodialysis. Nephrol Dial Transplant 2010; 25: 3458-3459
23. Alloatti S, Bosticardo GM, Torazza MC et al. Transcellular disequilibrium and intradialytic catabolism reduce the reliability of urea kinetic formulas. ASAIO Trans 1989; 35: 328-330
24. Malchesky MS, Nosse C, MagnussonM et al. Direct quantification of dialysis. Dial Transplant 1982; 11: 42-49
25. Garred LJ, Rittau M, Mc Cready W et al. Urea kinetic modelling by partial dialysate collection. Int J Artif Organs 1989; 12: 96-102
26. Malberti F, Corradi B, Tetta C et al. Calcium balance and serum ionized calcium fluctuations in on-line hemodiafiltration in relation to ultrafiltration rate and dialysate calcium concentration. Nephrol Dial Transplant 1994; 9: 1759-1764
27. Karohl C, Paschoal J, Martins de Caswtro MC et al. Effect of bone remodelling on calcium mass transfer during haemodialysis. Nephrol Dial Transplant 2010; 25: 1244-1251
28. Tentori F, Blayney MJ, Albert JM et al. Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: the Dialysis Outcomes and practice Patterns Study (DOPPS). Am J Kidney Dis 2008; 52: 519-530
29. National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003; 42: S1-201
30. Bushinsky DA. Contribution of intestine, bone, kidney, and dialysis to extracellular fluid calcium content. Clin J Am Soc Nephrol 2010; 5: S12-S22
31. Pun PH, Lehrich RW, Honeycutt EF et al. Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics. Kidney Int 2011; 79: 218-227
32. Basile C, Libutti P, Di Turo AL et al. Effect of dialysate calcium concentrations on parathyroid hormone and calcium balance during a single dialysis session using bicarbonate hemodialysis: a crossover clinical trial. Am J Kidney Dis 2012; 59: 92-101