Abstract
What is important in improving the prognosis of hemodialysis patients is to prevent vascular calcification by managing serum phosphorus and calcium. One of the strategies is to designate a dialysis calcium concentration. In this article, we explored the effect of a change in the dialysate calcium concentration from 3.0 to 2.75mEq/L on the serum PTH level for 12 weeks. Sixty-three stable patients on maintenance hemodialysis in our hospital were enrolled in this study. To investigate the effect of the change in the dialysate calcium concentration, we measured the serum adjusted calcium and phosphorus every 2 weeks, intact PTH and alkaline phosphatase every 4 weeks, and ionized calcium and bicarbonate at the baseline and at 12 weeks. Serum adjusted calcium levels after the change of dialysate were significantly lower during the follow-up period. On the other hand, the serum ionized calcium level did not decrease at 12 weeks. The serum phosphorus level and alkaline phosphatase were unchanged. The serum intact PTH level and ratio of PTH/baseline PTH were unchanged throughout the follow-up period. This can be explained by the course of ionized calcium. The serum bicarbonate level significantly decreased because the bicarbonate level of the dialysate was reduced from 30 to 27.5mEq/L. Consequently, ionized calcium as a proportion of the total calcium decreased. In conclusion, in this short-term study, the change of the dialysate calcium concentration from 3.0 to 2.75mEq/L did not affect the serum PTH level.
