A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis.
BACKGROUND:Calcium gradient, the difference between serum calcium and dialysate calcium d[Ca], is the main contributor factor influencing calcium transfer during hemodialysis. The impact, however, of bone turnover, on calcium mass transfer during hemodialysis is still uncertain. METHODS:This prospec...
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| Format: | Article |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC6066217?pdf=render |
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| author | Patricia Taschner Goldenstein Fabiana Giorgeti Graciolli Gisele Lins Antunes Wagner Vasques Dominguez Luciene Machado Dos Reis Sharon Moe Rosilene Motta Elias Vanda Jorgetti Rosa Maria Affonso Moysés |
| author_facet | Patricia Taschner Goldenstein Fabiana Giorgeti Graciolli Gisele Lins Antunes Wagner Vasques Dominguez Luciene Machado Dos Reis Sharon Moe Rosilene Motta Elias Vanda Jorgetti Rosa Maria Affonso Moysés |
| author_sort | Patricia Taschner Goldenstein |
| collection | DOAJ |
| description | BACKGROUND:Calcium gradient, the difference between serum calcium and dialysate calcium d[Ca], is the main contributor factor influencing calcium transfer during hemodialysis. The impact, however, of bone turnover, on calcium mass transfer during hemodialysis is still uncertain. METHODS:This prospective cross-sectional study included 10 patients on hemodialysis for a 57.6±16.8 months, with severe hyperparathyroidism. Patients were submitted to 3 hemodialysis sessions using d[Ca] of 1.25, 1.5 and 1.75 mmol/l in three situations: pre-parathyroidectomy (pre-PTX), during hungry bone (early post-PTX), and after stabilization of clinical status (late post-PTX). Biochemical analysis and calcium mass transfer were evaluated and serum bone-related proteins were quantified. RESULTS:Calcium mass transfer varied widely among patients in each study phase with a median of -89.5, -76.8 and -3 mmol using d[Ca] 1.25 mmol/L, -106, -26.8 and 29.7 mmol using d[Ca] 1.50 mmol/L, and 12.8, -14.5 and 38 mmol using d[Ca] 1.75 mmol/L during pre-PTX, early post-PTX and late post-PTX, respectively, which was significantly different among d[Ca] (p = 0.0001) and among phases (p = 0.040). Ca gradient and delta of Ca also differed among d[Ca] and phases (p<0.05 for all comparisons), whether ultrafiltration was similar. Serum Osteocalcin decreased significantly in late post-PTX, whereas Sclerostin increased earlier, in early post-PTX. CONCLUSIONS:The skeleton plays a key role in Ca mass transfer during dialysis, either by determining pre-dialysis serum Ca or by controlling the exchangeable Ca pool. Knowing that could help us to decide which d[Ca] should be chosen in a given patient. |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T15:42:43Z |
| publishDate | 2018-01-01 |
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| spelling | doaj.art-7f5eeaba3f324f3b962f9d6e6575a9ff2022-12-21T18:58:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01137e019894610.1371/journal.pone.0198946A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis.Patricia Taschner GoldensteinFabiana Giorgeti GraciolliGisele Lins AntunesWagner Vasques DominguezLuciene Machado Dos ReisSharon MoeRosilene Motta EliasVanda JorgettiRosa Maria Affonso MoysésBACKGROUND:Calcium gradient, the difference between serum calcium and dialysate calcium d[Ca], is the main contributor factor influencing calcium transfer during hemodialysis. The impact, however, of bone turnover, on calcium mass transfer during hemodialysis is still uncertain. METHODS:This prospective cross-sectional study included 10 patients on hemodialysis for a 57.6±16.8 months, with severe hyperparathyroidism. Patients were submitted to 3 hemodialysis sessions using d[Ca] of 1.25, 1.5 and 1.75 mmol/l in three situations: pre-parathyroidectomy (pre-PTX), during hungry bone (early post-PTX), and after stabilization of clinical status (late post-PTX). Biochemical analysis and calcium mass transfer were evaluated and serum bone-related proteins were quantified. RESULTS:Calcium mass transfer varied widely among patients in each study phase with a median of -89.5, -76.8 and -3 mmol using d[Ca] 1.25 mmol/L, -106, -26.8 and 29.7 mmol using d[Ca] 1.50 mmol/L, and 12.8, -14.5 and 38 mmol using d[Ca] 1.75 mmol/L during pre-PTX, early post-PTX and late post-PTX, respectively, which was significantly different among d[Ca] (p = 0.0001) and among phases (p = 0.040). Ca gradient and delta of Ca also differed among d[Ca] and phases (p<0.05 for all comparisons), whether ultrafiltration was similar. Serum Osteocalcin decreased significantly in late post-PTX, whereas Sclerostin increased earlier, in early post-PTX. CONCLUSIONS:The skeleton plays a key role in Ca mass transfer during dialysis, either by determining pre-dialysis serum Ca or by controlling the exchangeable Ca pool. Knowing that could help us to decide which d[Ca] should be chosen in a given patient.http://europepmc.org/articles/PMC6066217?pdf=render |
| spellingShingle | Patricia Taschner Goldenstein Fabiana Giorgeti Graciolli Gisele Lins Antunes Wagner Vasques Dominguez Luciene Machado Dos Reis Sharon Moe Rosilene Motta Elias Vanda Jorgetti Rosa Maria Affonso Moysés A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis. PLoS ONE |
| title | A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis. |
| title_full | A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis. |
| title_fullStr | A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis. |
| title_full_unstemmed | A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis. |
| title_short | A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis. |
| title_sort | prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis |
| url | http://europepmc.org/articles/PMC6066217?pdf=render |
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