Key result
Low calcium dialysate (1.25 mmol/L) significantly improved arterial compliance to 0.017 mm²/kPa compared to 0.013 mm²/kPa with high calcium dialysate (1.75 mmol/L) in hemodialysis patients (p<0.05).
Why the study?
Does low calcium dialysate improve arterial compliance and blood pressure in hemodialysis patients?
Does low calcium dialysate improve arterial compliance and blood pressure in hemodialysis patients?
Absolute Event Rate: 0.017% vs 0.013%
p-value: p=<0.05
Low calcium dialysate improves arterial compliance and reduces blood pressure in hemodialysis patients, potentially mediated by reduced serum ionized calcium and aldosterone.
Low-calcium dialysate was associated with improved arterial compliance in HD; leaves open need for RCTs before practice change.
BACKGROUND: Considering that dialysate calcium concentration is potentially a main determinant of the serum ionized calcium level and vasoconstriction is associated with the blood calcium concentration, we conducted a study to evaluate the interdialytic effects of treatment with a low calcium dialysate (LdCa, 1.25 mmol/L) on the changes in arterial compliance (AC), blood pressure (BP), biochemical parameters and vasoactive substances. METHODS: Eight hemodialysis (HD) patients (mean age: 46.8 +/- 13.7 years, 4 men and 4 women) were included in the study. AC, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), serum ionized Ca, intact-PTH, serum nitric oxide and aldosterone were compared after 10 sessions of treatment with LdCa. Right carotid artery diameter was measured 3 times using a real time B-mode ultrasound imager (Hewlett-Packard Sonos 2000) and AC was calculated using the Hayoz method. RESULTS: 1) AC was recorded as 0.140 (0.080-0.170) mm2/kPa at the baseline (1.75 mmol/L calcium dialysate), 0.170 (0.050-0.290) mm2/kPa after LdCa treatment (p < 0.05 versus baseline), and 0.140 (0.070-0.250) mm2/kPa following the HdCa treatment (p < 0.05 versus LdCa data). 2) MAP and PP were calculated at 114.12 +/- 10.56 mmHg and 63.50 +/- 10.87 mmHg at the baseline; 98.37 +/- 15.14 mmHg and 56.50 +/- 5.95 mmHg after LdCa treatment (p < 0.05 versus baseline); and 115.75 +/- 9.64 mmHg and 62.00 +/- 15.71 mmHg following HdCa treatment (p < 0.05 versus LdCa data). 3) Serum ionized Ca and intact-PTH were measured at 4.66 +/- 0.40 mg/dL and 25.08 +/- 16.44 pg/mL at the baseline; 4.45 +/- 0.28 mg/dL and 90.71 +/- 27.03 pg/mL after LdCa treatment (p < 0.05 versus baseline); and 4.65 0.43 mg/dL and 24.08 +/- 15.44 pg/mL following HdCa treatment (p < 0.05 versus LdCa data). 4) Serum aldosterone concentration was 300.8 (65.5-836.1) pg/mL at the baseline, and 220.2 (42.8-527.9) pg/mL after LdCa treatment (p < 0.05). CONCLUSION: There were favorable changes in AC, BP, biochemical parameters after treatment with LdCa. These changes may be associated with the reduction in serum ionized calcium and decreased serum aldosterone concentration.
No takes yet. Share an insight, caveat, or question.
Yoo et al. (2004) studied Hemodialysis (n=8). Low calcium dialysate vs. High calcium dialysate (1.75 mmol/L) was evaluated on Arterial compliance (mm2/kPa) (p=<0.05). Low calcium dialysate (1.25 mmol/L) significantly improved arterial compliance to 0.017 mm²/kPa compared to 0.013 mm²/kPa with high calcium dialysate (1.75 mmol/L) in hemodialysis patients (p<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: