ABSTRACT
To follow calcium metabolism in patients with a terminal stage of chronic renal failure who are on hemodialysis treatment is necessary for the assessment of phosphorus/calcium metabolism in a whole, efficiency of conservative treatment, indications to surgical intervention (parathyroidectomy, renal allotransplantation). The investigation included the assessment of total and ionized calcium blood plasma levels with regard to hemodialysis duration; the correlation of clinical and roentgenological picture of secondary hyperparathyroidism. A total of 222 patients were observed, and with regard to hemodialysis duration allocated into 5 groups: in the first hemodialysis lasted for not more than 3 mos; in the second--from 3 mos to 1 yr; third group with its duration from 1 to 2 yrs; fourth, when it lasted from 2 to 3 yrs; and the fifth group--hemodialysis lasted for more than 3 yrs. It was documented that disorders in calcium metabolism were increasing in parallel with the duration of hemodialysis. Clinical and roentgenological picture of hyperparathyroidism was accompanied by an evident increment of blood plasma ionized calcium while the levels of total blood calcium were but slightly changed. As a part of combined diagnosis ionized calcium assessment is helpful in early prevention and management of calcium metabolism disorders.
