Impact of dialysate calcium concentration on the progression of aortic stiffness in patients on haemodialysis

LeBoeuf, Amélie; Mac‐Way, Fabrice; Utescu, Mihai Silviu; Serres, Sacha A. De; Douville, Pierre; Desmeules, Simon; Lebel, Marcel; Agharazii, Mohsen

doi:10.1093/ndt/gfr138

Cited by 29 publications

(36 citation statements)

References 24 publications

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“…tic stiffness. Moreover, it should be kept in mind that several factors, other than PTH, are established determinants of arterial stiffening in patients with endstage renal disease 43) and include malnutrition, chronic volume overload, dialysated calcium and others [44][45][46] . Importantly, in the present study, inclusion of patients with a normal glomerular filtration rate allowed us to exclude most of these confounders.…”

Section: Resultsmentioning

confidence: 99%

Association of Parathyroid Hormone and 25-OH-Vitamin D Levels with Arterial Stiffness in Postmenopausal Women with Vitamin D Insufficiency

Pirro

Manfredelli

Helou

et al. 2012

JAT

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Section: Resultsmentioning

confidence: 99%

Association of Parathyroid Hormone and 25-OH-Vitamin D Levels with Arterial Stiffness in Postmenopausal Women with Vitamin D Insufficiency

Pirro

Manfredelli

Helou

et al. 2012

JAT

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“…They found that higher dialysate calcium concentration was a risk factor for the progression of aortic stiffness in HD patients. 14 Our previous study enrolled 40 PD patients, with dialysate calcium concentration of 1.25 mmol/L in 20 patients and 1.75 mmol/L in another 20 patients. After 12-month follow-up, low calcium dialysate treatment was associated with reduced number of newly occurring cardiovascular events in PD patients.…”

Section: Discussionmentioning

confidence: 99%

The influence of low calcium dialysate on left ventricular diastolic function in peritoneal dialysis patients

Wang

Wen

et al. 2016

Renal Failure

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Left ventricular (LV) diastolic function was found to be a significant predictor of cardiovascular events and general mortality in dialysis. Studies have indicated that dialysate calcium concentrations were significantly associated with cardiac function. However, the relationship between low calcium dialysate and LV diastolic function has not been clear. The aim of this study was to investigate the influence of low calcium dialysate on cardiac function in peritoneal dialysis (PD) patients. A total of 60 PD patients were enrolled in this study, with a calcium content of the PD solution of 1.25 mmol/L in 30 patients (low-calcium group) and 1.75 mmol/L in 30 patients (standard-calcium group). Standard M-mode and two-dimensional ultrasound measurements were applied to detect the cardiac function. After 12-month follow-up, we found no significant difference in blood pressure, calcium, phosphorus, parathyroid hormone (PTH), etc., between the two groups. Residual renal function (RRF), which is associated with LV cardiac function, was significantly decreased in the standard-calcium group compared with the low-calcium group (5.64 ± 3.23 vs. 9.38 ± 3.17, p ¼ .001). Compared with the low-calcium group, E max (peak early diastolic velocity) and A max (peak late diastolic velocity) were significantly decreased (p < .05), whereas myocardial performance index (MPI) was obviously increased in standard-calcium group (9.69 ± 2.71 vs. 7.75 ± 0.93, p < .05). In conclusion, our data suggest that low calcium dialysate treatment is significantly associated with better LV diastolic function. ARTICLE HISTORY

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“…Imbalances between factors that promote and factors that inhibit calcification interact with a positive balance or high concentrations of calcium and phosphate to promote vascular calcification [22,23,24]. Dialysis with high dialysate [calcium] has been associated to progression of arterial stiffness [25] while dialysis with 2.5 mEq/l dialysate calcium for 6 months decreased arterial stiffness [26]. Thus, it seems reasonable to avoid a calcium overload from dialysate in hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Individualization of Dialysate Calcium Concentration According to Baseline Pre-Dialysis Serum Calcium

et al. 2014

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Background: A positive calcium balance may contribute to vascular calcification, while a negative balance increases iPTH. We explored the impact of different dialysate calcium concentrations on bone and mineral metabolism parameters according to pre-dialysis serum calcium levels. Results: Fifty-six hemodialysis patients were dialyzed with 3.0 or 2.5 mEq/l dialysate [calcium] in a crossover study of two weeks. Bone mineral metabolites were measured prior to and following the hemodialysis session. A 3.0 mEq/l dialysate [calcium] increased more post-dialysis total calcium and ionized calcium than 2.5 mEq/l dialysate [calcium]. The mildest dialysis-induced changes in calcium and PTH were observed in patients with pre-dialysis serum calcium <8.75 mg/dl dialyzed with 2.5 mEq/l dialysate [calcium] and in patients with pre-dialysis serum calcium >9.15 mg/dl dialyzed with 3.0 mEq/l calcium dialysate. Conclusion: In conclusion, the individualization of dialysate calcium concentration according to baseline pre-dialysis serum calcium may prevent major excursions in post-dialysis serum calcium and iPTH levels. Short Summary: High calcium dialysate may increase serum calcium in hemodialysis patients, while low dialysate calcium may increase PTH. Individualization of dialysate calcium according to predialysis serum calcium levels may prevent or decrease unwanted excursions of both serum calcium and PTH.

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Impact of dialysate calcium concentration on the progression of aortic stiffness in patients on haemodialysis

Cited by 29 publications

References 24 publications

Association of Parathyroid Hormone and 25-OH-Vitamin D Levels with Arterial Stiffness in Postmenopausal Women with Vitamin D Insufficiency

Association of Parathyroid Hormone and 25-OH-Vitamin D Levels with Arterial Stiffness in Postmenopausal Women with Vitamin D Insufficiency

The influence of low calcium dialysate on left ventricular diastolic function in peritoneal dialysis patients

Individualization of Dialysate Calcium Concentration According to Baseline Pre-Dialysis Serum Calcium

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