A case of functional second degree atrioventricular block is reported in a preterm infant secondary to early onset hypocalcaemia. An infusion of 10% calcium gluconate rapidly corrected the arrhythmia. (Arch Dis Child Fetal Neonatal Ed 2001;85:F220-F221)
Background: The kidney has an important effect on minerals and bone metabolism in humans. Kidney is the target organ of many regulating hormones such as parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF-23), also it activates vitamin D. Abnormalities in phosphorus, calcium, vitamin D and parathyroid hormone are common in patients with chronic kidney disease (CKD). Objective: To compare the effect of online hemodiafiltration (HDF) dialysis versus high flux hemodialysis on bone markers. Patients and Methods: The study was performed on 50 prevalent hemodialysis (HD) patients in Ain Shams University Specialized Hospital on high flux dialysis and were divided into 2 groups (group 1), 25 patients who continued hemodialysis with high flux dialyzer and (group 2), 25 patients who were shifted to online HDF. Bone specific alkaline phosphatase (BSAP), calcium, phosphorus, blood urea nitrogen (BUN), creatinine, sodium, potassium and blood hemoglobin were measured at the start of this study and after 4 months. Only Parathyroid hormone (PTH) was measured at the end of the study in both groups. Results: there was significant increase BSAP and significant reduction of phosphorus levels after 4 months with online HDF compared to high flux HD; p value 0.036 and <0.001 respectively. Conclusion:Online HDF has significant effect on bone markers and phosphorus clearance than high flux Hemodialysis but we need more prospective with longer durations studies to confirm this effects.
Background The kidney plays a vital role in the metabolism of minerals and bone health. It is not only the target organ of several regulating hormones such as parathormon (PTH) and fibroblast growth factor-23 (FGF-23), but it is also the main organ that activates vitamin D. Calcium and phosphorus are fundamentally important in a wide array of biological functions. Abnormalities in calcium, phosphorus, parathyroid hormone (PTH), and vitamin D metabolism (usually referred to as disordered mineral metabolism) are common in patients with (CKD). Aim of the work Comparing the effect of hemodiafiltration (HDF) versus conventional Hemodialysis on bone markers. Patients and Methods The study was performed on 50 patients in Ain Shams University Specialized Hospital with end-stage renal failure treated by means of chronic hemodialysis (n = 25) and hemodiafiltration (n = 25). Inclusion criteria were end stage renal disease patients on regular hemodialysis for > 6 months, their age> 18 years old, no recent infection (normal CRP), cardiac or vascular access complication, none of the patients had history of bone disease, fracture or malignancy. As regarding blood transfusion and drug intake (affect bone metabolism or hemostasis) had not administered for 1 month perior to study. Results Both groups had lower levels of serum creatinine before and after sessions of HD or HDF but Hemodialysis (HD) patients has higher levels of phosphate and bone ALP, than patients on HDF. Conclusion Hemodiafiltration (HDF) has better effect on bone metabolism than Hemodialysis (HD).
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