TY - JOUR
T1 - Comparison between different dialysate calcium concentrations in nocturnal hemodialysis
AU - Toussaint, Nigel David
AU - Polkinghorne, Kevan R
AU - Kerr, Peter
AU - Somerville, Christine A
AU - Agar, John
PY - 2007
Y1 - 2007
N2 - Benefits of dialysate with greater calcium (Ca) concentration are reported in nocturnal hemodialysis
(NHD) to prevent Ca depletion and subsequent hyperparathyroidism. Studies with patients dialyzing
against 1.25 mmol/L Ca baths demonstrate increases in alkaline phosphatase (ALP) and parathyroid
hormone (PTH) and increasing dialysate Ca subsequently corrects this problem. However, whether
1.5 or 1.75 mmol/L dialysate Ca is most appropriate for NHD is yet to be determined, and differences
in the effect on mineral metabolism of daily vs. alternate daily NHD have also not been well defined.
We retrospectively analyzed mineral metabolism in 48 patients, from 2 institutions (30 at Monash
and 18 at Geelong), undergoing home NHD (8 hr/night, 3.5a??6 nights/week) for a minimum of 6
months. Thirty-seven patients were dialyzed against 1.5 mmol/L Ca bath and 11 patients against
1.75 mmol/L. We divided patients into 4 groups, based on dialysate Ca and also on the hours per
week of dialysis,o40 (1.5 mmol/L, n=29 and 1.75 mmol/L, n=8) or 40 (n=4 and 7). We compared
predialysis and postdialysis serum markers, time-averaged over a 6-month period, and the administration
of calcitriol and Ca-based phosphate binders between 1.5 and 1.75 mmol/L Ca dialysate
groups. Baseline characteristics between all groups were similar, with a slightly longer, but nonsignificant,
duration of NHD in both 1.75 mmol/L dialysate groups compared with 1.5 mmol/L.
AB - Benefits of dialysate with greater calcium (Ca) concentration are reported in nocturnal hemodialysis
(NHD) to prevent Ca depletion and subsequent hyperparathyroidism. Studies with patients dialyzing
against 1.25 mmol/L Ca baths demonstrate increases in alkaline phosphatase (ALP) and parathyroid
hormone (PTH) and increasing dialysate Ca subsequently corrects this problem. However, whether
1.5 or 1.75 mmol/L dialysate Ca is most appropriate for NHD is yet to be determined, and differences
in the effect on mineral metabolism of daily vs. alternate daily NHD have also not been well defined.
We retrospectively analyzed mineral metabolism in 48 patients, from 2 institutions (30 at Monash
and 18 at Geelong), undergoing home NHD (8 hr/night, 3.5a??6 nights/week) for a minimum of 6
months. Thirty-seven patients were dialyzed against 1.5 mmol/L Ca bath and 11 patients against
1.75 mmol/L. We divided patients into 4 groups, based on dialysate Ca and also on the hours per
week of dialysis,o40 (1.5 mmol/L, n=29 and 1.75 mmol/L, n=8) or 40 (n=4 and 7). We compared
predialysis and postdialysis serum markers, time-averaged over a 6-month period, and the administration
of calcitriol and Ca-based phosphate binders between 1.5 and 1.75 mmol/L Ca dialysate
groups. Baseline characteristics between all groups were similar, with a slightly longer, but nonsignificant,
duration of NHD in both 1.75 mmol/L dialysate groups compared with 1.5 mmol/L.
UR - http://www3.interscience.wiley.com.ezproxy.lib.monash.edu.au/cgi-bin/fulltext/118498942/PDFSTART
U2 - 10.1111/j.1542-4758.2007.00172.x []
DO - 10.1111/j.1542-4758.2007.00172.x []
M3 - Article
VL - 11
SP - 217
EP - 224
JO - Hemodialysis International
JF - Hemodialysis International
SN - 1492-7535
IS - 2
ER -