The effect of dialysate calcium levels on blood pressure during hemodialysis |
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| Authors: | R A Sherman G B Bialy B Gazinski A S Bernholc R P Eisinger |
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| Affiliation: | 1. Institute of Nano Science and Technology, Mohali, India;2. Neurobiology Lab, Department of Zoology, University of Allahabad, Allahabad, India;3. CSIR-Central Drug Research Institute, Lucknow, India;1. Department of Biochemistry and Molecular Biology, School of Medicine, Universidad Nacional Autónoma de México, Mexico City, 04510, Mexico;2. Department of Toxicology and Pharmacology, Faculty of Chemistry, Universidad Autónoma del Estado de México, Mexico;3. Grenoble Institut des Neurosciences, Université Joseph Fourier, LabEx Ion Channel Science and Therapeutics, France;4. Department of Biochemistry, National Institute of Perinatology, Mexico;1. Department of Radiodiagnosis, PGIMER, Chandigarh 160012, India;2. Department of Gastroenterology, PGIMER, Chandigarh, India;3. Department of General Surgery, PGIMER, Chandigarh, India;1. Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;2. Department of Health Sciences, Division of Community & Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;3. Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada;4. Department of Biostatistics and Clinical Epidemiology, McMaster University, Hamilton, Ontario, Canada;5. The Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada;6. Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, USA;7. Department of Anaesthesia & Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada |
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| Abstract: | A controlled double-blind prospective study was undertaken of the effect of dialysate calcium levels on BP during hemodialysis. Twenty patients and 240 dialyses were studied using a protocol in which patients underwent alternate hemodialyses with dialysate calcium of 2.5 and 3.5 mEq/L. Dialysate composition was otherwise the same. Mean BPs during dialysis were significantly lower at 1.5, 2.5, and 3.5 hours of dialysis when the lower dialysate calcium was used (P = .007 to .02). However, the difference in BP between the high and low dialysate calcium treatments was clinically minor, with a maximum mean difference (at 1.5 hours) of 4.6 mm Hg. Subgroups of patients with frequent hypotension and low or normal serum calcium did not appear more sensitive to the hypotensive effect of low calcium dialysate. Dialysate calcium levels of 2.5 and 3.5 mEq/L thus differ in their effect on intradialytic BP in a statistically significant, but clinically minor, way. Low calcium dialysate thus may prove useful in the management of patients in whom large amounts of enteric calcium absorption are indicated or unavoidable. |
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