Individualization of Dialysate Calcium Concentration According to Baseline Pre-Dialysis Serum Calcium

2014 ◽  
Vol 38 (3-4) ◽  
pp. 224-233 ◽  
Author(s):  
Emilio Gonzalez-Parra ◽  
Maria Luisa Gonzalez-Casaus ◽  
Maria Dolores Arenas ◽  
Valeria Sainz-Prestel ◽  
Liliana Gonzalez-Espinoza ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Dialysate Calcium

Effects of Lowering Dialysate Calcium Concentration on Carotid Intima-Media Thickness and Aortic Stiffness in Patients Undergoing Maintenance Hemodialysis: A Prospective Study

2016 ◽  
Vol 42 (4) ◽  
pp. 337-346 ◽  
Author(s):  
Zhangxiu He ◽  
Lei Cui ◽  
Chunyuan Ma ◽  
Hong Yan ◽  
Tanyong Ma ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Chinese Patients ◽  
Maintenance Hemodialysis ◽  
Cox Regression Analysis ◽  
Media Thickness ◽  
Average Change ◽  
Dialysate Calcium

Background and Aim: The study aimed to prospectively evaluate the effects of lowering the dialysate calcium concentration (DCa) to 1.25 mmol/l on Chinese patients undergoing maintenance hemodialysis (MHD), which are largely unknown to date. Methods: A singer-center, prospective, randomized trial was conducted for 2 years. The DCa in one group was decreased from 1.5 to 1.25 mmol/l but there was no change in the other group. The clinical outcomes, biochemical parameters, medicine treatments and markers of vascular change were compared among the 2 groups at different time intervals. Results: At baseline, the groups were similar with respect to serum levels of calcium, phosphorus, intact parathyroid hormone and fibroblast growth factor-23 as well as carotid intima-media thickness (cIMT) and carotid-femoral pulse wave velocity (cf-PWV). It was found that the serum phosphorus concentration in the lower DCa group had decreased markedly at 2-year follow-up (0-month: 7.13 ± 1.56 mg/dl; 24-month: 5.92 ± 1.73 mg/dl; p = 0.005). Serum calcium (p = 0.018), cIMT (p = 0.029) and cf-PWV (p = 0.024) in DCa 1.25 group were significantly lower than those in 1.5 group at the 24-month visit. Kaplan-Meier curve revealed that patients in DCa 1.25 group had a better rate of survival. In the multivariate Cox regression analysis, cIMT (HR 1.010; 95% CI 1.002-1.217; p = 0.015) and cf-PWV (HR 1.265; 95% CI 1.022-1.567; p = 0.031) were potential risk factors for mortality in those patients. Importantly, we showed that the average change in these 2 risk variables were both associated with the average change in levels of serum calcium and phosphorus. Conclusion: Our results indicate that lowering DCa to 1.25 mmol/l may be suitable for the MHD patients in our unit.

scholarly journals Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis

2020 ◽  
Author(s):  
Rosilene M. Elias ◽  
Sharon Moe ◽  
Rosa M. A Moysés
Keyword(s):  
Mass Transfer ◽  
Vascular Calcification ◽  
Serum Calcium ◽  
Calcium Concentration ◽  
Myocardial Dysfunction ◽  
Organ Damage ◽  
Calcium Balance ◽  
Direct Effects ◽  
Dialysate Calcium ◽  
Existing Data

Abstract Patients on hemodialysis are exposed to calcium via the dialysate at least three times a week. Changes in serum calcium vary according to calcium mass transfer during dialysis, which is dependent on the gradient between serum and dialysate calcium concentration (d[Ca]) and the skeleton turnover status that alters the ability of bone to incorporate calcium. Although underappreciated, the d[Ca] can potentially cause positive calcium balance that leads to systemic organ damage, including associations with mortality, myocardial dysfunction, hemodynamic tolerability, vascular calcification, and arrhythmias. The pathophysiology of these adverse effects includes serum calcium changes, parathyroid hormone suppression, and vascular calcification through indirect and direct effects. Some organs are more susceptible to alterations in calcium homeostasis. In this review, we discuss the existing data and potential mechanisms linking the d[Ca] to calcium balance with consequent dysfunction of the skeleton, myocardium, and arteries.

Calcium Excretion and Serum Calcium Concentration in Adult Intact and Gonadectomized Rats

Endocrinology ◽  
1968 ◽  
Vol 83 (6) ◽  
pp. 1375-1376 ◽  
Author(s):  
BERNARD F. RICE ◽  
ROY PONTHIER ◽  
M. CLINTON MILLER
Keyword(s):  
Serum Calcium ◽  
Calcium Concentration ◽  
Calcium Excretion ◽  
Serum Calcium Concentration

Effect of Hypocalcemia on Cardiac Function in Very-Low-Birth-Weight Preterm Neonates: Studies of Blood Ionized Calcium, Echocardiography, and Cardiac Effect of Intravenous Calcium Therapy

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 543-550
Author(s):  
Pankaja S. Venkataraman ◽  
Don A. Wilson ◽  
Roger E. Sheldon ◽  
Radhakrishna Rao ◽  
Michael K. Parker
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cardiac Function ◽  
Serum Calcium ◽  
Calcium Concentration ◽  
Very Low Birth Weight ◽  
Left Ventricular ◽  
Ionized Calcium ◽  
Total Calcium ◽  
Serum Total Calcium

Traditionally, in infants, a serum calcium value less than 7.0 mg/dL is considered to impair cardiac function. In very-low-birth-weight infants, we studied the hypotheses that decline in serum calcium to 6.0 mg/dL (1) would not impair cardiac function and (2) ionized calcium would remain greater than 3.0 mg/dL. We also evaluated the effect of calcium infusion on cardiac function. We studied 15 normokalemic and normonatremic infants whose birth weights were 822 to 1,450 g and were less than 32 weeks' gestation. When serum calcium declined to less than 6.0 mg/dL, 18 mg/kg of calcium as 5% calcium gluconate was infused for 10 minutes. Serum total calcium concentration, blood ionized calcium concentration, ECG, and M-mode echocardiogram were obtained on entry into the study, when the infants were hypocalcemic, immediately after treatment with calcium, and eight hours after treatment. Ionized calcium values were calculated based on serum total calcium and serum protein, and corrected calcium values were calculated based on serum total calcium, serum albumin, and blood pH. In all infants, serum calcium value declined to less than 7.0 and in eight infants to less than 6.0 mg/dL. Assessment of heart rate, systolic blood pressure, ejection fraction, left ventricular systolic time interval, right ventricular systolic time interval, fiber shortening index, and left ventricular mean velocity of circumferential fiber shortening showed no significant alteration from baseline during hypocalcemia or in association with intravenous slow bolus infusion of 18 mg/kg of calcium. In association with a decline in serum total calcium to as low as 6.0 mg/dL, whole blood ionized calcium was maintained at more than 3.0 mg/dL. Serum total calcium and calculated ionized calcium values correlated significantly with measured blood ionized calcium concentrations; however, these measures were not reliable predictors of blood ionized calcium. We speculate that the hypoproteinemia and hypoalbuminemia noted in these infants may result in relative protection of the blood ionized calcium in these infants. We suggest that in neonates with wide ranges in gestation, serum protein, and blood pH levels, total serum calcium and calculated ionized calcium values may be poor measures of derangement of calcium metabolism. Decline in total serum calcium concentration to 6.0 mg/dL was not associated with impaired cardiac function, and slow bolus calcium infusion in these hypocalcemic very-low-birth-weight infants neither improved nor impaired cardiac function.

Individualizing the dialysate calcium concentration

2015 ◽  
Vol 24 (6) ◽  
pp. 538-545 ◽  
Author(s):  
Guillaume Jean ◽  
Charles Chazot
Keyword(s):  
Calcium Concentration ◽  
Dialysate Calcium

scholarly journals Effects of Ammonium Chloride Supplements on Serum Calcium Concentration in Pre-parturient Dairy Cows

2002 ◽  
Vol 55 (4) ◽  
pp. 219-222 ◽  
Author(s):  
Naoto SUZUKI ◽  
Akihiro DAIRAKU ◽  
Tomio KATAGAI ◽  
Gensei TSUNODA ◽  
Kazuyuki SUZUKI ◽  
...  
Keyword(s):  
Dairy Cows ◽  
Ammonium Chloride ◽  
Serum Calcium ◽  
Calcium Concentration ◽  
Serum Calcium Concentration

scholarly journals Effect of the first and second postpartum partial milking on blood serum calcium concentration in dairy cows

2014 ◽  
Vol 59 (No. 3) ◽  
pp. 128-133
Author(s):  
E.G. Salgado-Hernández ◽  
A. Aparicio-Cecilio ◽  
F.H. Velásquez-Forero ◽  
D.A. Castillo-Mata
Keyword(s):  
Blood Serum ◽  
Dairy Cows ◽  
Serum Calcium ◽  
Metabolic Disorders ◽  
Calcium Concentration ◽  
Atomic Absorption Spectrophotometry ◽  
Serum Calcium Concentration ◽  
Group 2 ◽  
Group 1

Parturient paresis and subclinical hypocalcemia are frequent metabolic disorders in dairy cows postpartum. The aim of this study was to determine the effect of postpartum partial milking in the first two milkings on blood serum calcium concentration in dairy cows. Twenty multiparous Holstein dairy cows were randomized into two groups. Cows of group 1 (n = 10) were partially milked at the first and second milking postpartum. Cows of group 2 (n = 10) were completely milked. Blood samples were collected from all animals 5–7 days before calving, within 30 min after calving, and 4, 8, 12, 16, 20, 24, 28, and 32 h after calving for determination of serum calcium (Ca), phosphorus (P), and magnesium (Mg) concentrations. Colostrum production was registered and sampled in the first and second milking. Concentration of Ca in colostrum was determined by atomic absorption spectrophotometry. Serum Ca and P concentrations decreased in both groups after parturition (P < 0.05) and remained low during 32 h postpartum with no difference observed between groups (P > 0.05). Serum concentrations of Mg were stable in all samples and no statistical difference was observed between groups (P > 0.05). Colostrum production was higher in completely milked cows only in the first postpartum milking (P < 0.05), but there was no difference between groups at the second milking. Total Ca secretion in colostrum was higher in the complete milking group at the first and second postpartum milking. Colostrum Ca secretion increased at the second milking with respect to the first one in both groups (P < 0.05). There was no correlation between serum Ca and colostrum Ca (P > 0.05). In this study, the partial milking of colostrum in the first and second milking postpartum did not prevent subclinical hypocalcemia in dairy cows.  

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