Intradialytic alkalinization is a neglected factor affecting calcium mass balance and parathyroid hormone level during haemodiafiltration
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F19%3A10394628" target="_blank" >RIV/00064203:_____/19:10394628 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/19:10394628
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=-8sWxBtBBE" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=-8sWxBtBBE</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1093/ckj/sfy047" target="_blank" >10.1093/ckj/sfy047</a>
Alternative languages
Result language
angličtina
Original language name
Intradialytic alkalinization is a neglected factor affecting calcium mass balance and parathyroid hormone level during haemodiafiltration
Original language description
Background The diffusion gradient between ionized calcium (iCa) in the inlet dialysate and blood is considered to be the main driving force of calcium mass balance (CMB). The intradialytic change of parathyroid hormone (PTH) level corresponds to the change in plasma iCa. In contrast to the widely discussed calcium concentration of dialysis solution, the dialysate pH and bicarbonate concentration (DHCO3), important factors affecting the level of iCa, have not been studied with respect to the intradialytic change of plasma PTH level (PTH) and CMB. Methods We measured PTH and CMB (calcium flux from the dialysate to the patient) in 10 stable patients on haemodiafiltration. All patients underwent two treatments differing in DHCO3 (26 versus 32mmol/L). The dialysate calcium concentration was 1.25mmol/L for all treatments. Results We found significant difference in PTH, which decreased with 26_DHCO3 and slightly increased with 32_DHCO3 (-110.5 versus+19.7pg/mL, P<0.01). CMB was negative for both DHCO3, but with higher DHCO3 there was a trend to minor intradialytic loss of calcium (-108 versus -309mg). Conclusions DHCO3 increase at first glance leads to contrasting phenomena: the intradialytic rise of PTH and calcium gain. Both processes are caused by a pH-dependent decrease of plasma iCa, resulting in parathyroid stimulation and intradialytic increase of iCa diffusion gradient. We found no significant correlation between CMB and intradialytic change of plasma total Ca. With respect to plasma PTH level and CMB, the bicarbonate concentration should always be taken into account when selecting the optimal dialysis solution.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30217 - Urology and nephrology
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2019
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Clinical Kidney Journal
ISSN
2048-8505
e-ISSN
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Volume of the periodical
12
Issue of the periodical within the volume
1
Country of publishing house
GB - UNITED KINGDOM
Number of pages
8
Pages from-to
149-156
UT code for WoS article
000469506700023
EID of the result in the Scopus database
2-s2.0-85054762909