Hemodialysis with high-calcium dialysate impairs cardiac relaxation

Näppi, Satu; Saha, Heikki; Virtanen, Vesa; Mustonen, Jukka; Pasternack, Amos

doi:10.1046/j.1523-1755.1999.0550031091.x

Cited by 23 publications

(27 citation statements)

References 24 publications

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“…who demonstrated an association between increasing serum calcium and mortality in conventional dialysis patients. Other studies have also suggested that high D Ca may have deleterious effects on the cardiovascular system 24–26 . However, high serum calcium levels may have a lesser adverse effect on cardiovascular health in patients in whom serum phosphate is normalized.…”

Section: Discussionmentioning

confidence: 99%

Mineral metabolism, bone histomorphometry and vascular calcification in alternate night nocturnal haemodialysis

Eps¹,

Jeffries²,

Anderson

et al. 2007

Nephrology

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Alternate nightly home haemodialysis effectively manages biochemical parameters of BMM. Patients with very high PTH at baseline (>1000 ng/L) did not significantly improve parathyroid hormone status. Abnormal bone turnover and mineralization were present in a significant proportion of patients at 12 months but low turnover was uncommon. Vascular calcification was stabilized or improved in the majority. ANHHD compares favourably with every night and short daily therapy in relation to BMM management and may offer lifestyle advantages for patients.

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Section: Discussionmentioning

confidence: 99%

Mineral metabolism, bone histomorphometry and vascular calcification in alternate night nocturnal haemodialysis

Eps¹,

Jeffries²,

Anderson

et al. 2007

Nephrology

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“…Our previous studies showed that the induction of hypercalcemia by calcium infusion [18]or by hemodialysis with a high-calcium dialysate [19]acutely impairs cardiac relaxation without affecting LV systolic function. The present results would indicate that chronic hypercalcemia is even more harmful to the myocardium; patients with PHPT had LVH, impaired cardiac diastolic function and slightly impaired systolic function which did not improve after 2–3 months of normocalcemia.…”

Section: Discussionmentioning

confidence: 99%

“…We have previously shown that the acute induction of hypercalcemia significantly impairs cardiac relaxation but has no effect on LV systolic function [18, 19]. The present study was designed to establish whether LV structure, systolic or diastolic function are affected by chronic hypercalcemia in patients with PHPT.…”

Section: Introductionmentioning

confidence: 94%

Left Ventricular Structure and Function in Primary Hyperparathyroidism before and after Parathyroidectomy

et al. 2000

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Objective: Our aim was to study the effect of primary hyperparathyroidism (PHPT) and parathyroidectomy (PTX) on left ventricular (LV) wall thicknesses and systolic and diastolic function. Methods: Fifteen patients with untreated PHPT were evaluated by applying Doppler and digitized M-mode echocardiography before and 2–3 months after PTX. Fifteen age- and sex-matched healthy controls were also examined echocardiographically. Results: Prior to PTX, interventricular septal thickness (IVST), LV mass (LVM), aortic root dimension and left atrium dimension were greater and LV fractional shortening was slightly decreased in patients as compared to controls. Significantly increased LV peak late diastolic velocity (A_max) and isovolumic relaxation time, and a slightly decreased ratio of peak early to peak late diastolic velocities (E/A_max) in the patients indicated impairment of LV diastolic function in hyperparathyroidism. PTX reduced serum total Ca from 2.79 ± 0.13 to 2.39 ± 0.09 mmol/l (p < 0.001) and tended to reduce IVST [10.6 ± 2.1 vs. 10.4 ± 2.0 mm; not significant (n.s.)], LV posterior wall thickness (9.6 ± 2.0 vs. 9.2 ± 1.0 mm, n.s.) and LVM (250 ± 102 vs. 213 ± 42 g; n.s.). Before PTX, there was a significant correlation between serum total Ca and LVM (r = 0.63, p < 0.05), and the PTX-induced change in serum total calcium correlated with the change in LVM (r = 0.59, p < 0.05). PTX induced no significant changes in LV systolic or diastolic function during the follow-up of 2–3 months. Conclusions: The present findings indicate that PHPT induces LV hypertrophy, slight impairment of LV systolic function and significant impairment of LV diastolic function, which are not substantially improved after TX and 2–3 months of normocalcemia.

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“…2 Compared with lower calcium dialysate (1.25 or 1.5 mmol/L) treatment, standard calcium (1.75 mmol/ L) dialysate impaired left ventricular (LV) cardiac function in hemodialysis (HD) and PD patients. 3,4 Kim et al…”

Section: Introductionmentioning

confidence: 99%

The influence of low calcium dialysate on left ventricular diastolic function in peritoneal dialysis patients

Wang

Wen

et al. 2016

Renal Failure

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Left ventricular (LV) diastolic function was found to be a significant predictor of cardiovascular events and general mortality in dialysis. Studies have indicated that dialysate calcium concentrations were significantly associated with cardiac function. However, the relationship between low calcium dialysate and LV diastolic function has not been clear. The aim of this study was to investigate the influence of low calcium dialysate on cardiac function in peritoneal dialysis (PD) patients. A total of 60 PD patients were enrolled in this study, with a calcium content of the PD solution of 1.25 mmol/L in 30 patients (low-calcium group) and 1.75 mmol/L in 30 patients (standard-calcium group). Standard M-mode and two-dimensional ultrasound measurements were applied to detect the cardiac function. After 12-month follow-up, we found no significant difference in blood pressure, calcium, phosphorus, parathyroid hormone (PTH), etc., between the two groups. Residual renal function (RRF), which is associated with LV cardiac function, was significantly decreased in the standard-calcium group compared with the low-calcium group (5.64 ± 3.23 vs. 9.38 ± 3.17, p ¼ .001). Compared with the low-calcium group, E max (peak early diastolic velocity) and A max (peak late diastolic velocity) were significantly decreased (p < .05), whereas myocardial performance index (MPI) was obviously increased in standard-calcium group (9.69 ± 2.71 vs. 7.75 ± 0.93, p < .05). In conclusion, our data suggest that low calcium dialysate treatment is significantly associated with better LV diastolic function. ARTICLE HISTORY

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Hemodialysis with high-calcium dialysate impairs cardiac relaxation

Abstract: HD with high-calcium (dCa++1. 75 mmol/liter) dialysate impairs LV relaxation when compared with lower calcium dialysate (dCa++1.25 and dCa++1.5 mmol/liter) treatments.

Cited by 23 publications

References 24 publications

Mineral metabolism, bone histomorphometry and vascular calcification in alternate night nocturnal haemodialysis

Mineral metabolism, bone histomorphometry and vascular calcification in alternate night nocturnal haemodialysis

Left Ventricular Structure and Function in Primary Hyperparathyroidism before and after Parathyroidectomy

The influence of low calcium dialysate on left ventricular diastolic function in peritoneal dialysis patients

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