Effect of Haemodialysis on Erythrocyte and Plasma Potassium, Magnesium, Sodium and Calcium

Abstract

Erythrocyte and plasma potassium, magnesium, sodium and calcium were estimated before and after dialysis in 32 studies on 14 patients undergoing recurrent haemodialysis. Predialysis erythrocyte magnesium was raised while sodium and calcium were depressed. Erythrocyte potassium varied depending on the total body potassium status of the patient. During dialysis erythrocyte potassium and magnesium fell but sodium and calcium increased. Changes in erythrocyte water or blood pH did not account for the shift of erythrocyte cations during dialysis. With recurrent dialysis changes in erythrocyte cations reflected the cumulative effect of individual dialysis and were towards a normal erythrocyte electrolyte composition. Erythrocyte magnesium resisted depletion despite low serum levels. Low dialysate magnesium levels (0.3–0.5 mg/100 ml) are required to maintain near normal serum and cellular magnesium concentrations.

The Effect of Low Magnesium Dialysate on Plasma, Ultrafiltrable, Erythrocyte and Bone Magnesium Concentrations from Patients on Maintenance Haemodialysis

“…The results indicate that even in this region with the low magnesium content of the drinking water, prolonged dialysis did not deplete erythrocytes or bone of the excess levels of magnesium found in chronic renal failure. This finding over a period of 60 months corresponds with the previously reported results of short-term studies [10,22], In three patients studied, the decreased plasma and ultrafiltrable magnesium levels detected after dialysis returned to normal levels within 4 h. Whether the temporary fall in plasma magnesium concentration induced by dialysis ( fig. 1) is important in provoking an increased response from the para thyroid glands, thus exacerbating any tendency to metabolic bone disease, is not established.…”

On the Effect of Magnesium on the PTH Secretion in Uremic Patients on Maintenance Hemodialysis

“…In our patients undergoing hemodialysis with different Mg concentrations in the dialysate, the Mg serum levels paralleled the Mg level changes in the dialysis bath, thus confirming previous findings [11][12][13][14][15]. Although the changes of the Mg serum levels were statistically significant and were maintained for 6 months, they were not associated with any significant variation of the PTH serum levels.…”

The Relationship between Hematocrit and Erythrocyte Magnesium Concentration in Patients on Regular Hemodialysis

“…Our investigation showed an inverse relationship be tween the erythrocyte Mg concentration and Ht in patients on chronic dialysis. This finding could account for the high concentrations found by other authors who probably ex amined only uremic patients with low Ht [1,[3][4][5][6], as also for the wide range of the erythrocyte Mg concentration found by Catto el al. [2], who probably studied patients having a broad range of Ht.…”

“…On the contrary, Johny el at. [3] pointed out that the high erythrocyte Mg levels in uremia are probably related to a marked resistance to cellular depletion despite low serum Mg levels, and Cano el al. [2] confirmed that low Mg fluid in prolonged dialysis did not deplete the erythrocytes of their Mg content.…”