Related Experiment Video

Updated: Jul 15, 2026

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
11:30

A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro

Published on: June 2, 2022

Arterial stiffness alterations during hemodialysis: the role of dialysate calcium

John Kyriazis1, Irene Katsipi, Kostas Stylianou

  • 1Department of Nephrology, General Hospital of Chios, Chios, Greece. jks@otenet.gr

Nephron. Clinical Practice
|April 6, 2007
PubMed

Insights

High dialysate calcium (dCa) increases arterial stiffness (AS) during hemodialysis (HD), independent of blood pressure. Low dCa may reduce cardiovascular risk by preventing AS increases and hypercalcemia in HD patients.

Area of Science:

  • Nephrology
  • Cardiovascular Physiology
  • Biomedical Engineering

Background:

  • Dialysate calcium (dCa) levels are a key factor in hemodialysis (HD) prescription.
  • Arterial stiffness (AS) is a significant predictor of cardiovascular risk.
  • The impact of varying dCa on AS during HD is not fully understood.

Purpose of the Study:

  • To investigate the influence of low (1.25 mmol/l) versus high (1.75 mmol/l) dCa concentrations on arterial stiffness (AS) during hemodialysis.
  • To assess changes in stiffness index (SI) and reflection index (RI) as measures of AS.
  • To determine if these changes are independent of blood pressure variations.

Main Methods:

  • Fourteen HD patients participated in a randomized crossover study comparing low dCa (LdCa) and high dCa (HdCa) treatments.
  • Arterial stiffness parameters (SI, RI) were measured using digital volume pulse (DVP) analysis before and during HD.
  • Ionized serum calcium (iCa), blood pressure (BP), and heart rate (HR) were monitored throughout the study.

Main Results:

  • High dCa (HdCa) significantly increased SI and RI by 5.7% and 6%, respectively.
  • Low dCa (LdCa) did not alter SI or RI, and prevented the increase seen with HdCa.
  • Serum ionized calcium (iCa) increased in the HdCa group and decreased in the LdCa group, with no significant differences in BP or HR between groups.

Conclusions:

  • High dCa, but not low dCa, induces a significant, blood pressure-independent increase in arterial stiffness during hemodialysis.
  • Low dCa hemodialysis may mitigate cardiovascular risk by preventing intradialytic increases in arterial stiffness and hypercalcemia.
  • Optimizing dCa levels in HD prescriptions could be a strategy to reduce cardiovascular complications in patients.
Abstract

More Related Videos

Assessment of Vascular Function in Patients With Chronic Kidney Disease08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Related Concept Videos

Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Skeleton and Calcium Homeostasis01:21

Skeleton and Calcium Homeostasis

Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...