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Intradialytic Calcium Kinetics and Cardiovascular Disease in Chronic Hemodialysis Patients

Markus Pirklbauer1, Lisa Fuchs2, Ramona Heiss2

  • 1Department of Internal Medicine IV - Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria, markus.pirklbauer@i-med.ac.at.

Blood Purification
|July 27, 2020
PubMed

Insights

Intradialytic calcium buffering plays a role in hemodialysis (HD) patients, influencing cardiovascular risk. Understanding intradialytic calcium kinetics may help assess cardiovascular disease burden in this population.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biochemistry

Background:

  • Calcium loading is linked to cardiovascular risk in hemodialysis (HD) patients.
  • The contribution of intradialytic calcium buffering to cardiovascular disease burden in HD patients requires further investigation.

Purpose of the Study:

  • To evaluate intradialytic calcium kinetics in chronic HD patients.
  • To assess the relationship between intradialytic calcium buffering, cardiovascular parameters, and biomarkers.

Main Methods:

  • Cross-sectional observational study of 40 chronic HD patients.
  • Measurement of dialysate-sided ionized calcium mass balance (iCaMB), calcium buffer capacity, and serum calcium changes during HD.
  • Assessment of aortic pulse wave velocity, serum osteocalcin, cardiovascular disease, and diabetes.

Main Results:

  • Mean intradialytic calcium buffer capacity was 73%.
  • Higher serum calcium increase (∆iCa) was associated with coronary heart disease.
  • Intradialytic calcium buffer capacity correlated with undercarboxylated osteocalcin.

Conclusions:

  • Clinical evidence supports a role for intradialytic calcium regulation and osteocalcin as a biomarker.
  • Further prospective trials are warranted to evaluate the prognostic potential of intradialytic calcium kinetics.
Abstract

Keywords:
Calcium mass balanceCardiovascular diseaseExchangeable calcium poolHemodialysisOsteocalcin

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