Parathyroid hormone secretion during citrate anticoagulated hemodialysis in acutely ill maintenance hemodialysis patients.

Anesthesia and Analgesia
R ApsnerG Sunder-Plassmann

Abstract

Regional citrate anticoagulation during extracorporeal treatment is used in patients at risk for hemorrhage. We conducted a prospective clinical trial on the effect of large- versus small-dose calcium supplementation during citrate anticoagulated hemodialysis on ionized calcium and intact parathyroid hormone (iPTH). Twenty-five treatments were studied in 25 patients with active bleeding or at risk for hemorrhage. Sixteen patients received large-dose calcium (15 mmol/h), and 9 received small-dose calcium (5 mmol/h) substitution during treatment. Ionized calcium increased in 13 of 16 patients in the large-dose calcium group and decreased in 8 of 9 patients in the small-dose calcium group. Intact PTH decreased by 25% in the large-dose group and increased by 121% in the small-dose group (P = 0.0007 for Delta; P = 0.007 for Delta%). In the 14 patients in whom ionized calcium increased, iPTH decreased. In 10 of 11 patients in whom ionized calcium decreased, iPTH increased. The increase or decrease of ionized calcium was more predictive for changes in iPTH than was the calcium-substitution rate (R(2) = 0.5526 versus 0.3962, respectively). We conclude that the behavior of iPTH can be influenced in a predictive manner by adjusting the c...Continue Reading

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Citations

May 23, 2014·Medizinische Klinik, Intensivmedizin und Notfallmedizin·R D Frank
Mar 9, 2005·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Robert ApsnerGere Sunder-Plassmann
Jun 1, 2011·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Jakob GubenšekJadranka Buturović-Ponikvar
Jul 6, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Santo MorabitoEnrico Fiaccadori
Aug 28, 2020·The International Journal of Artificial Organs·Xiao BiFeng Ding
Jun 18, 2016·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Jadranka Buturovic-Ponikvar

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