Effects of Lowering Dialysate Calcium Concentrations on Arterial Stiffness in Patients Undergoing Hemodialysis
The Korean Journal of Internal Medicine
; : 320-327, 2011.
Article
de En
| WPRIM
| ID: wpr-35156
Bibliothèque responsable:
WPRO
ABSTRACT
BACKGROUND/AIMS: We assessed changes in hemodynamic and arterial stiffness parameters following reductions of dialysate calcium concentrations in patients undergoing hemodialysis. METHODS: In this prospective study, 20 patients on maintenance hemodialysis (10 females, 10 males) with dialysate calcium concentrations of 1.75 mmol/L were enrolled. At the start of the study, the dialysate calcium level was lowered to 1.50 mmol/L. Serial changes in biochemical, hemodynamic, and arterial stiffness parameters, including pulse wave velocity (PWV) and augmentation index (AIx), were assessed every 2 months for 6 months. We also examined changes in the calcification-inhibitory protein, serum fetuin-A. RESULTS: During the 6-month study period, serum total calcium and ionized calcium decreased consistently (9.5 +/- 1.0 to 9.0 +/- 0.7, p = 0.002 vs. 1.3 +/- 0.1 to 1.1 +/- 0.1, p = 0.035). Although no apparent changes in blood pressure were observed, heart-femoral PWW (hf-PWV) and AIx showed significant improvement (p = 0.012, 0.043, respectively). Repeated-measures ANOVA indicated a significant effect of lowering dialysate calcium on hf-PWV (F = 4.58, p = 0.004) and AIx (F = 2.55, p = 0.049). Accompanying the change in serum calcium, serum fetuin-A levels significantly increased (95.8 +/- 45.8 pmol/mL at baseline to 124.9 +/- 82.2 pmol/mL at 6 months, p = 0.043). CONCLUSIONS: Lowering dialysate calcium concentration significantly improved arterial stiffness parameters, which may have been associated with upregulation of serum fetuin-A.
Mots clés
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Artères
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Facteurs temps
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Pression sanguine
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Écoulement pulsatoire
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Marqueurs biologiques
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Solutions d'hémodialyse
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Calcium
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Études prospectives
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Analyse de variance
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Dialyse rénale
Type d'étude:
Observational_studies
Limites du sujet:
Aged
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Female
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Humans
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Male
Pays comme sujet:
Asia
langue:
En
Texte intégral:
The Korean Journal of Internal Medicine
Année:
2011
Type:
Article