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Calcium-free dialyzate: development and applications.

M Kaye¹, E Barber, M Vasilevsky

¹Division of Nephrology, Montreal General Hospital, Quebec, Canada.

Clinical Nephrology

|March 1, 1989

Summary

This summary is machine-generated.

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A new hemodialysis concentrate, free of calcium and rich in bicarbonate, was developed. It proved safe and effective in over 300 treatments, showing no significant differences compared to standard bicarbonate dialysis.

Area of Science:

Nephrology
Biochemistry
Medical Technology

Background:

Standard hemodialysis solutions often require careful calcium management.
Bicarbonate-buffered solutions are preferred for acid-base balance during dialysis.

Purpose of the Study:

To develop and evaluate a novel calcium-free, bicarbonate-containing concentrate for hemodialysis.
To assess the safety, efficacy, and calcium balance of this new concentrate.

Main Methods:

Preparation of a hemodialysis concentrate with specific sodium, chloride, and bicarbonate concentrations.
Clinical evaluation comparing the new concentrate with standard bicarbonate dialysis in patients.
Monitoring of blood chemistries, patient symptoms, and calcium loss during dialysis.

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Main Results:

The diluted concentrate achieved target concentrations: sodium 146 mmol/l, Cl 110 mmol/l, HCO3 35 mmol/l, pH 8.3.
No significant differences in blood chemistries, symptoms, or signs were observed compared to standard bicarbonate dialysis.
Over 300 dialyses, the system was trouble-free, with predictable calcium loss (40.6 +/- 1.1 mmol) managed by venous calcium infusion.

Conclusions:

The calcium-free, bicarbonate-containing concentrate is a safe and effective alternative for hemodialysis.
It allows for controlled calcium replacement and may help avoid hypercalcemia in specific patient populations.
The concentrate has potential applications in citrate anticoagulation and managing patients on oral calcium therapy.