Comparison of intradialytic calcium changes between bicarbonate dialysate and acetate dialysate in chronic hemodialysis patients

ABSTRACT

Renal osteodystrophy affects patients with end- stage renal failure, resulting in significant skeletal and extra- skeletal morbidity. The aim of the work is to study the intradialytic changes of calcium, phosphorus and parathyroid hormone [PTI-l] in acetate and bicarbonate dialysis. The present study was conducted on 10 chronic renal failure patients [their age ranged from 19 to 60 years and consisted of 7 males 3 females] selected from Ain Shams University Specialized Hospital on regular hemodialysis thrice weekly 4 hours each, first using acetate dialysate and investigations were done then patients were shifted to bicarbonate dialysate and the same investigations were done [Ionized calcium, phosphorous and parathyroid hormone] measured at start of hemodialysis session, after 2 hours from start of session and at the end of session. All patients were ordered to fix their dry weight, protein diet [about 0.8-1gm/Kg/day] and current medications. Non of patients had diabetes, neoplasia, liver disease, cachexia or had been previously parathyroidectomised. This study demonstrated that, calcium level significantly increased in bicarbonate dialysate session and did riot significantly increase in acetate dialysate sessions. Phosphorus level significantly decreased in both acetate and bicarbonate session. PTH level did not significantly decrease in both types of dialysate but in three patients [one in bicarbonate and 2 in acetate], PTH level was markedly raised