Effects of on-line hemodiafiltration regimens and dialysate composition on serum concentrations of magnesium and calcium ions

Renal Replacement Therapy

Daisuke Okada¹  Ryosuke Hatonari¹  Yusaku Tanaka¹  Hiroyuki Michiwaki¹  Tomohiro Tao¹  Seiichiro Wariishi²  Jun Minakuchi³  Hisato Shima³ 

[1] Clinical Engineering Department of Kawashima Hospital, 1-39 Kitasakoichiban-cho, 770-0011, Tokushima, Tokushima, Japan;Department of Cardiovascular Surgery, Kawashima Hospital, 1-39 Kitasakoichiban-cho, 770-0011, Tokushima, Japan;Department of Kidney Disease, Kawashima Hospital, 1-39 Kitasakoichiban-cho, 770-0011, Tokushima, Tokushima, Japan;

关键词: Citrate dialysate;    Ionized calcium;    Ionized magnesium;    On-line hemodiafiltration;    Standard dialysate;   

DOI  :  10.1186/s41100-021-00345-9

来源: Springer

【 摘 要 】

BackgroundLow-ionized magnesium and high-ionized calcium levels are associated with increased cardiovascular mortality in patients undergoing dialysis. We examined the effects of the dilution method, substitution volume, and dialysate of on-line hemodiafiltration on the total and ionized magnesium and calcium levels.MethodsEighteen patients were randomly assigned to three dialysate groups: two acetic acid dialysate groups and one citrate dialysate group. Five treatment conditions were applied: pre-diluted on-line hemodiafiltration, post-diluted on-line hemodiafiltration, and hemodialysis.ResultsThe total and ionized serum levels of magnesium and calcium were evaluated and found to be unaffected by the dilution methods and substitution volumes. The albumin leakage was approximately 3 g/session under the pre-dilution and hemodiafiltration conditions, and approximately 4–5 g/session under the post-dilution condition. The ionized magnesium concentration decreased in the citrate dialysate group.ConclusionThe on-line hemodiafiltration parameters had a negligible effect on ionized magnesium and calcium; however, the use of citrate dialysate decreased the ionized magnesium levels, probably because of chelation.Trial registration000028172. The study was registered on July 11 2017.

【 授权许可】

CC BY