Abstract:

Objective To evalute the acute effects of different calcium concentration dialysate on arterial blood pressure (BP)and calcium balance in maintenance hemodialysis (MHD) patients with normal serum tCa,and to provide scientific basis for individualized calcium concentration dialysate formula. Methods Dialysate with different calcium concentration (1.25mmol/L、1.5mmol/L、1.75mmol/L) as DCa1.25, DCa1.5 and DCa1.75 was used in seventeen stable MHD patients.Arterial blood pressure was measured before and after each dialysis session,and every 30 minutes during hemodialysis session. Serum total calcium and ionized calcium was assessed before and after each dialysis session with different calcium concentration dialysate.Results With the DCa1.25,BP,serum tCa and iCa decreased as compared with pre-dialysis values (P ＜0.05).With the DCa1.5, no signifiCant changes of BP,serum tCa and iCa between pre-dialysis and post-dialysis was found. With the DCa1.75,BP,serum tCa and iCa increased signifiCantly as compared with pre-dialysis values (P＜0.01). Conclusions DCa 1.5 can be used in MHD patients with normol BP and normol serum tCa or slight hypocalcemia. DCa1.25 can be used shortly in MHD patients with hypertension and hypercalcemia. DCa1.75 is suitable for MHD patients with hypotension and hypocalcemia. In a word,calcium concentration in dialysate can not be on the same level in all MHD patients, more attention should pay to individualized clciunconlen tration dialysate formula.

Key words: Blood pressure, Total calcium, Ionized calcium