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Published on: April 14, 2016
Apheresis affects bone and mineral metabolism
Karin Amrein1, Claudia Katschnig, Sabine Sipurzynski
1Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Austria. karin.amrein@klinikum-graz.at
Bone
|November 20, 2009
Summary
Regular apheresis, using citrate, acutely impacts bone and mineral metabolism, leading to reduced bone mineral density (BMD) at the lumbar spine in donors. Long-term strategies to protect bone health are needed.
Area of Science:
- Hematology
- Bone Metabolism
- Biochemistry
Background:
- Apheresis selectively collects blood components, commonly using citrate as an anticoagulant.
- Citrate binds ionized calcium, inhibiting coagulation and potentially causing metabolic alkalosis.
Purpose of the Study:
- To investigate the acute effects of apheresis on acid-base balance, bone, and mineral metabolism.
- To compare bone mineral density (BMD) in regular apheresis donors versus matched controls.
Main Methods:
- An observational, cross-sectional study involving 102 regular plasma and thrombocyte donors and 102 controls.
- Measurements included serum levels of calcium, phosphate, base excess, PTH, and BMD at the lumbar spine and hip.
Main Results:
- Platelet donation caused acute drops in ionized calcium and phosphate, with significant increases in base excess and PTH.
- Donors showed lower baseline serum calcium, albumin, and 25-hydroxyvitamin D.
- Lumbar spine BMD (Z-score) was significantly lower in donors compared to controls, even after adjustments.
Conclusions:
- Citrate in apheresis acutely alters mineral and bone metabolism.
- Regular blood component donation negatively impacts lumbar spine BMD.
- Further research is needed to develop preventive strategies for long-term bone health in donors.
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