Abstract: Objective To evaluate the effects of different calcium concentration in citrate bicarbonate versus acetate bicarbonate buffered dialysate in maintenance hemodialysis (MHD) patients. Methods Sixteen stable MHD patients were treated with the citrate bicarbonate buffered dialysate containing Ca+2 1.75
mmol/L (DCa l.75), 1.5 mmol/L (DCa l.5) and 1.25 mmol/L (DCa l.25) each for one week for 3 weeks, and then with the acetate bicarbonate buffered dialysate containing Ca+2 1.75 mmol/L (DCa l.75), 1.5 mmol/L (DCa l.5) and 1.25 mmol/L (DCa l.25) each for one week for another period of 3 weeks. Serum total Ca (tCa), ionized Ca (iCa) and mean arterial pressure (MAP) were measured before and after the hemedialysis using each kind of dialysate. Results ① tCa and iCa increased and MAP unchanged in patients using either citrate bicarbonate or acetate bicarbonate buffered dialysate with DCa l.75. ② tCa and iCa increased in patients using acetate bicarbonate buffered dialysate with DCa 1.5, but unchanged in those using citrate bicarbonate buffered dialysate with DCa 1.5. MAP unchanged using either citrate bicarbonate or acetate bicarbonate buffered dialysate with DCa l.5. ③ tCa and iCa decreased and MAP lowered from 97±16 to 86±21 mmHg (P<0.05) in patients using citrate bicarbonate buffered dialysate with DCa l.25, and 25% of these patients experienced perspiration, muscle cramps and discomfort. tCA decreased and iCa and MAP unchanged in those using acetate bicarbonate buffered dialysate with DCa l.25. Conclusion tCa, iCa and MAP were relatively stable in MHD patients using citrate bicarbonate buffered dialysate containing 1.5 mmol/L calcium.

Key words: Citrate bicarbonate dialysate, Calcium, BIood pressure, Hemodialysis