Different calcium concentration Citrate dialysate consequences on calcium and PTH in hemodialysis patients / 中华肾脏病杂志

ABSTRACT

Objective To evaluate the effects on the mineral bone disorder using different calcium concentration citrate-based dialysate in maintenance hemodialysis (MHD) patients.To compare the concentrations of intact parathyroid hormone(PTH) with biointact PTH(1-84) in these patients.Methods Citrate dialysate with different calcium concentration (DCa 1.75,DCa 1.5,DCa 1.25 mmol/L)were used in turn in 15 stable MHD patients each week.Serum tCa and iCa were measured by automatic biochemistry analyzer.The concentrations of iPTH and bio-iPTH were compared.Results (1) The patients treated with DCa 1.75 citrate dialysate had increased serum iCa and tCa after dialysis,and PTH did not change significantly as compared to those findings before the dialysis.With the DCa 1.5 citrate dialysate,serum iCa and tCa were kept stable and PTH level was increased.With DCa 1.25 citrate dialysate,serum iCa and tCa decreased significantly and PTH decreased.(2)iPTH and bioPTH had excellent correlations.Variation of bio-iPTH was more correlated with the changes of calcium than iPTH.Conclusions Serum levels of iPTH,tCa and iCa can be kept stable in MHD patients treated with DCa 1.75 ～ 1.5 citrate dialysate.Bio-iPTH is a more sensitive marker for mineral bone disease than iPTH.