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The relation between the serum calcium level and the complication incidence in haemodialysis uremic patients
Ante Kvesić1, Martina Soljić, Gordan Galić
1University Hospital Mostar, Mostar, Bosnia and Herzegovina.
Insights
Low serum calcium levels (hypocalcemia) in hemodialysis patients are linked to increased infection and sepsis incidence. Further research is needed to explore this association and reduce patient morbidity and mortality.
Area of Science:
- Nephrology
- Mineral Metabolism
- Infectious Diseases
Background:
- Mineral metabolism disorders significantly impact morbidity and mortality in hemodialysis patients.
- Infections are frequent complications in this population.
- While high calcium and phosphorus levels are studied, the impact of low levels is less understood.
Purpose of the Study:
- To investigate the relationship between low serum calcium levels (hypocalcemia) and complication incidence, particularly infections, in hemodialysis patients.
- To assess the association between hypocalcemia and overall complication rates.
Main Methods:
- An observational study over 18 months.
- Inclusion of 120 hemodialysis uremic patients.
- Monitoring of serum calcium levels and complication incidence, including infections and sepsis.
Main Results:
- 63.3% of patients exhibited hypocalcemia (serum calcium < 9.0-9.5 mg/dL).
- Hypocalcemic patients showed significantly higher incidence of infections (p=0.0468), sepsis (p=0.04), and total complications (p<0.05).
- A trend towards higher vascular access local infection incidence was observed but not statistically significant (p=0.7598).
Conclusions:
- Low serum calcium concentration (hypocalcemia) is associated with increased complication incidence in hemodialysis patients, especially infections.
- Further research on vascular access infections in a larger cohort is warranted.
- Findings suggest a need for therapeutic strategies targeting hypocalcemia to reduce morbidity and mortality.
Abstract:
The mineral metabolism disorder is the most influential factor of the morbidity and mortality incidence of haemodialysis uremic patients. The second most influential factor is the infection, which is the most frequent complication with an undesirable outcome. In recent times, the relation of the increased serum calcium and phosphorus level on the one hand, and the morbidity and mortality of that population in case on the other, has been observed. However, insufficient professional and scientific thought has been given to the relation of the lower serum levels of the aforementioned minerals and the morbidity and mortality incidence. We have researched the relation between lower serum calcium level (hypocalcaemia) and the complication incidence, especially infection. Throughout the time period of 18 months, 120 haemodialysis uremic patients were observed and 76 (63.3%) of them had serum calcium level below the lower threshold of referent values (9.0-9.5 mg/dL). In the patients with a lower serum calcium level (hypocalcaemia) a significant infection incidence (chi2 = 3.99; p = 0.0468), a significant sepses incidence (chi2 = 8.016; p = 0.04), a significant total complication incidence (p < 0.05) were determined, as well as a higher vascular access local infection incidence, but without statistically significant research results of this relation (chi2 = 0.098; p = 0.7598). We are of the belief that the incidence of the vascular access local infection should be examined on a greater number of patients; therefore, the significance of the examined relation in such an instance would be expected. The total infection incidence in all 120 observed patients is 3.8 for 100 months. It is to be concluded that the research findings indicate the association regarding the appearance of low serum calcium concentration (hypocalcaemia) and an increased complication incidence, especially the inflammation that leads to the requirement of further research in order to decrease morbidity, and consequently also the mortality of the observed population of patients by means of programmed therapy approach.
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