Studying the role of calcium concentration in dialysate in the rise of blood pressure during hemodialysis sessions

Background: The change of blood pressure during hemodialysis has been noted for long time. However, there were few studies on the rise of blood pressure during hemodialysis. The clinical meaning of hypertension during hemodialysis has not been understood clearly. Objective: To study the role of calcium concentration in dialysate in the rise of blood pressure during hemodialysis sessions. Subjects and method: Prospective study performed on 9 stable patients on chronic hemodialysis treated at Viet Duc Hospital including 5 female and 4 male patients. The mean age of patients was 47.6 years. The patients had period 1 of 10 weeks of treatment using dialysate 1 A (with calcium concentration 1.8 mmol/l) and then they were switched to period 2 of 10 other weeks using dialysate 3A (with calcium concentration 1.25 mmol/l). Results:The blood pressure of patients during the period 2 using 3A dialysate was better controlled during hemodialysis sessions. The response to erythropoietin treatment was similar in both periods. The serum calcium was lower after using 3A dialysate. Conclusions: Using dialysate with lower calcium concentration can be helpful for controlling the hypertension during hemodialysis sessions. The appropriate calcium concentration in dialysate needs to be selected to avoid the hypocalcaemia in chronic hemodialysis patients.

Adverse effects of some anti-cold preparation

Our study included 14 patients admitted to Bachmai hospital because of headache and hypertension after taking anti-cold preparations (Rhumenol Decolgen, Decolsin, and Medicoldac) from 3/2002 to 6/2002. These patients had no history of hypertension and took antiflu tablets according to instruction of manufacturers. On admission, all patients had hypertension with the maximum BP 190/120mmHg. The first-degree atrioventricular block was observed in 1 case. The adverse effects may be caused by overdose of phenylpropanolamine, a sympathomimetic agent. Our study is a warning of dangerous reality of broadly advertising, marketing and abusing drugs. The manufacturers should consider the amount of Phenylpropanolamine in anti-cold preparations to avoid the adverse effect.