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Does long term haemofiltration provoke secondary hyperparathyroidism?

H Schneider, E Streicher, H Schmidt-Gayk

Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association

|January 1, 1978

Summary

Haemofiltration can reduce calcium intake and magnesium levels, increasing parathyroid hormone (PTH) while decreasing vitamin D. Supplementation with Vitamin D is recommended to prevent secondary hyperparathyroidism.

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Area of Science:

Nephrology
Renal Replacement Therapy

Background:

Haemofiltration is a renal replacement therapy used since 1976.
Previous studies have not fully elucidated the long-term metabolic consequences of haemofiltration.

Purpose of the Study:

To evaluate the metabolic balance and hormonal changes associated with haemofiltration.
To assess the impact of haemofiltration on calcium, magnesium, phosphate, PTH, and vitamin D levels.

Main Methods:

Analysis of 1,949 haemofiltration procedures using four different haemofilters.
Gravimetric and volumetric haemofiltration machines were employed.
Balance studies were conducted to assess nutrient and mineral exchange.

Main Results:

Calcium intake was reduced by approximately one-third compared to conventional dialysis.

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Negative magnesium balance led to decreased serum magnesium levels.

Parathyroid hormone (PTH) levels increased, while 25-hydroxyvitamin D3 (25-OH-D3) levels decreased significantly.

Gamma-c globulin was detected in filtrate, and 25-OH-D3 was found in trace amounts.

Conclusions:

Haemofiltration significantly impacts mineral and vitamin D metabolism.
Vitamin D supplementation is crucial to counteract losses and prevent secondary hyperparathyroidism.
Further research into optimal haemofiltration protocols and supplementation strategies is warranted.