scholarly journals The change of the dialysate calcium concentration from 3.0 to 2.75mEq/L did not affect the serum PTH level in hemodialysis patients

2012 ◽  
Vol 45 (9) ◽  
pp. 873-880 ◽  
Author(s):  
Akiko Matsuura ◽  
Daisuke Inaguma ◽  
Daisuke Itawaki ◽  
Tomoko Sumi ◽  
Hoshiaki Nakagawa ◽  
...  
Keyword(s):  
Calcium Concentration ◽  
Hemodialysis Patients ◽  
Serum Pth ◽  
Dialysate Calcium ◽  
Pth Level

The Influence of Dialysate Calcium Concentration on the Pth Level in Children Undergoing Capd

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 567-569 ◽  
Author(s):  
Maria Sieniawska ◽  
Maria Roszkowska-Blaim ◽  
Beata Wojciechowska
Keyword(s):  
Mass Transfer ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Dwell Time ◽  
Calcium Concentration ◽  
Vitamin D Metabolites ◽  
Intact Parathyroid Hormone ◽  
Gland Function ◽  
Dialysate Calcium ◽  
Pth Level

In 12 children aged four-and-a-half to 18 years (mean 11 ±4.2) undergoing continuous ambulatory peritoneal dialysis (CAPO), serum intact parathyroid hormone (iPTH), ionized calcium (iCa) levels, and calcium mass transfer (CaMT) were measured on three consecutive days: day 1, after a four-hour interval between dialyses; on day 2, after four hours dwell time with peritoneal dialysis (PD) Ca 3.5 mEq/L; and on day 3, after four hours dwell time with PD Ca 2.5 mEq/L. A significantly more negative CaMT was found when PD Ca 2.5 mEq/L was used, as compared with values obtained using PD Ca 3.5 mEq/L. Significantly lower parathyroid hormone (PTH) values were found after the interval between exchanges. We conclude that in order to properly evaluate parathyroid gland function and to decide whether or not to give vitamin D metabolites, a protocol for determining PTH should be standardized.

Impact of lowering dialysate calcium concentration on serum bone turnover markers in hemodialysis patients

Bone ◽  
2005 ◽  
Vol 36 (5) ◽  
pp. 909-916 ◽  
Author(s):  
T HAMANO ◽  
S OSETO ◽  
N FUJII ◽  
T ITO ◽  
M KATAYAMA ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Bone Turnover Markers ◽  
Calcium Concentration ◽  
Hemodialysis Patients ◽  
Turnover Markers ◽  
Dialysate Calcium

scholarly journals Effects of dialysate calcium concentration on calcium-phosphorus metabolism in hemodialysis patients

2010 ◽  
Vol 43 (11) ◽  
pp. 933-938
Author(s):  
Nobuo Shinkai ◽  
Masahiro Yanase ◽  
Yuki Kyoda ◽  
Motoi Takeuchi ◽  
Fumiyasu Takei ◽  
...  
Keyword(s):  
Calcium Concentration ◽  
Hemodialysis Patients ◽  
Phosphorus Metabolism ◽  
Calcium Phosphorus ◽  
Dialysate Calcium

scholarly journals Hysteresis of the parathyroid hormone response to hypocalcemia in hemodialysis patients with low turnover aluminum bone disease.

1991 ◽  
Vol 2 (6) ◽  
pp. 1136-1143
Author(s):  
A J Felsenfeld ◽  
D Ross ◽  
M Rodriguez
Keyword(s):  
Parathyroid Hormone ◽  
Serum Calcium ◽  
Bone Disease ◽  
Calcium Concentration ◽  
Hemodialysis Patients ◽  
Ionized Calcium ◽  
Total Serum ◽  
High Calcium ◽  
The Mean ◽  
Pth Level

During the study of parathyroid function in 19 hemodialysis patients with low turnover aluminum bone disease, it was observed that serum parathyroid hormone (PTH) levels were higher during the induction of hypocalcemia than during the recovery from hypocalcemia. This type of PTH response has been termed hysteresis. Hypocalcemia was induced during hemodialysis with a calcium-free dialysate. When the total serum calcium level decreased to 7 mg/dL, the dialysate calcium concentration was changed to 3.5 mEq/L and the dialysis session was completed. One week later, hypercalcemia was induced during hemodialysis with a high-calcium dialysate. The mean basal PTH level was 132 +/- 37 pg/mL (normal, 10 to 65 pg/mL; immunoradiometric (IRMA), Nichols Institute, San Juan Capistrano, CA) and increased to a maximal PTH level of 387 +/- 91 pg/mL during hypocalcemia. For the same ionized calcium concentration, the PTH level was higher during the induction of hypocalcemia than during the recovery from hypocalcemia. Conversely, for the same ionized calcium concentration, the PTH level was greater when hypercalcemia was induced from the nadir of hypocalcemia than when hypercalcemia was induced from basal serum calcium. The set point of calcium (defined as the serum calcium concentration required to reduce maximal PTH by 50%) was greater during the induction of hypocalcemia than during the recovery from hypocalcemia (4.44 +/- 0.10 versus 4.25 +/- 0.09 mg/dL; P = 0.03). The mean basal ionized calcium concentration and the mean ionized calcium concentration at the intersection of the two PTH-calcium curves were the same (4.61 +/- 0.13 versus 4.61 +/- 0.12 mg/dL).(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Impact of Dialysate Calcium Concentration on Clinical Outcomes in Incident Hemodialysis Patients

Medicine ◽  
2015 ◽  
Vol 94 (40) ◽  
pp. e1694 ◽  
Author(s):  
Hyung Wook Kim ◽  
Su-Hyun Kim ◽  
Young Ok Kim ◽  
Dong Chan Jin ◽  
Ho Chul Song ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Calcium Concentration ◽  
Hemodialysis Patients ◽  
Dialysate Calcium

Effects of low dialysate calcium concentration on health-related quality of life in hemodialysis patients

2005 ◽  
Vol 9 (2) ◽  
pp. 153-157 ◽  
Author(s):  
Yoshinori Taji ◽  
Takeshi Morimoto ◽  
Shunichi Fukuhara ◽  
Tsuguya Fukui ◽  
Takashi Kuwahara
Keyword(s):  
Quality Of Life ◽  
Calcium Concentration ◽  
Hemodialysis Patients ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Dialysate Calcium

Long-term effects of reducing the dialysate calcium concentration on bone biomarkers in adult patients on peritoneal dialysis

2021 ◽  
Author(s):  
Maria Piraciaba ◽  
Lilian Cordeiro ◽  
Erica Adelina Guimarães ◽  
Hugo Abensur ◽  
Benedito Jorge Pereira ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Calcium Concentration ◽  
Long Term Effects ◽  
Bone Biomarkers ◽  
25 Oh Vitamin D ◽  
One Year ◽  
Serum Pth ◽  
Dialysate Calcium

Abstract Introduction: Patients on peritoneal dialysis (PD) are usually exposed to a high dialysate calcium concentration (D[Ca]), which is associated with undesirable effects. Low D[Ca] might overstimulate parathyroid hormone (PTH), as shown by previous studies carried out before the incorporation of calcimimetics in clinical practice. We hypothesized that a reduction in D[Ca] is safe and without risk for a rise in serum PTH. Methods in this prospective study, the D[Ca] was reduced from 1.75 mmol/L to 1.25 mmol/L for one year in prevalent patients on PD. Demographic, clinical, and biochemical parameters were evaluated at baseline, 3, 6, and 12 months of follow-up. Results Patients (N = 20) aged 56 ± 16 years, 50% male, 25% diabetic. There was no significant change in calcium, phosphate, alkaline phosphatase, 25(OH)-vitamin D or PTH over time. Medication adjustments included an increase in calcitriol and sevelamer. After 1 year, absolute and percentual change in PTH levels were 36 (-58, 139) pg/ml, and 20% (-28, 45) respectively. The proportion of patients with PTH > 300 pg/ml did not change during the follow-up (p = 0.173). Conclusion Low D[Ca] concentration should be considered to patients on PD as a valuable and safe option. Medication adjustments to detain PTH rising, however, are advised.

P1417ALTERED CATHEPSIN-K LEVELS REFLECT SEVERITY OF MINERAL BONE DISEASE AND INFLAMMATION IN CHRONIC HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Giuseppe Coppolino ◽  
Marta Greco ◽  
Giuseppe Leonardi ◽  
Michele Provenzano ◽  
Omar Tripolino ◽  
...  
Keyword(s):  
Bone Disease ◽  
Calcium Concentration ◽  
Cathepsin K ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Future Research ◽  
Dialysis Session ◽  
Dialysis Patients ◽  
Dialysis Vintage ◽  
Dialysate Calcium

Abstract Background and Aims Mineral bone disease (MBD) and chronic inflammation are key triggers of the exceeding cardiovascular risk that characterizes dialysis patients. Cathepsin-K (Cts-K) is a lysosomal cysteine protease involved in bone remodeling and resorption, whose expression is promoted particularly by inflammation and whose involvement in bone and cardiovascular disorders has previously been demonstrated. We set out to undertake an exploratory, observational study to assess the possible clinical significance of Cts-K in dialysis patients. Method Eighty-five chronic HD patients (mean age 67±12, median dialysis vintage 3.2 yrs) with stable dry weight were studied. Cts-K was measured in peripheral blood samples before a mid-week dialysis session together with standard biochemical parameters. Twenty-six healthy subjects, matched with HD patients for age and gender, served as controls. Results Cts-K was statistically higher in HD patients than in controls (median 340, IQR 170-835 vs. 190 IQR 20-120 pg/mL, p<0.0001). At univariate analyses, Cts-K levels were significantly associated with ALP (r=0.50, p<0.001), CRP (r=0.46, p<0.001), PTH (r=0.24,p=0.02), presence of diabetes (r=0.28,p<0.001),peripheral vasculopathy (r=0.20, p=0.05) and dialysate calcium concentration (r=-0.28,p<0.001). In a multivariate model including all univariate predictors (R2=61%, p<0.001) only ALP (β=0.70,p<0.001), CRP (β=0.49,p<0.001) and dialysate calcium concentration (β -0.40,p=0.04) remained significantly associated with Cts-K levels. Interestingly, Cts-K levels were significantly higher among individuals who were under active calcimimetic therapy (n=28; p<0.001) but significantly lower among those who previously underwent parathyroidectomy (n=8; p<0.001) (Figure 1). Conclusion Cathepsin-K is a biomarker at the crossroads of bone and inflammatory disorders in chronic hemodialysis patients. Future research is needed to clarify the exact pathophysiological role of this protein and to test its potential usefulness as a marker for managing MBD therapy and complications.

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