A prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGOLDENSTEIN, Patricia Taschner
dc.contributor.authorGRACIOLLI, Fabiana Giorgeti
dc.contributor.authorANTUNES, Gisele Lins
dc.contributor.authorDOMINGUEZ, Wagner Vasques
dc.contributor.authorREIS, Luciene Machado dos
dc.contributor.authorMOE, Sharon
dc.contributor.authorELIAS, Rosilene Motta
dc.contributor.authorJORGETTI, Vanda
dc.contributor.authorMOYSES, Rosa Maria Affonso
dc.date.accessioned2018-09-13T15:27:40Z
dc.date.available2018-09-13T15:27:40Z
dc.date.issued2018
dc.description.abstractBackground Calcium gradient, the difference between serum calcium and dialysate calcium d[Ca], is the main contributor factor influencing calcium transfer during hemodialysis. The impact, however, of bone turnover, on calcium mass transfer during hemodialysis is still uncertain. Methods This prospective cross-sectional study included 10 patients on hemodialysis for a 57.6 +/- 16.8 months, with severe hyperparathyroidism. Patients were submitted to 3 hemodialysis sessions using d[Ca] of 1.25, 1.5 and 1.75 mmol/l in three situations: pre-parathyroidectomy (pre-PTX), during hungry bone (early post-PTX), and after stabilization of clinical status (late post-PTX). Biochemical analysis and calcium mass transfer were evaluated and serum bone-related proteins were quantified. Results Calcium mass transfer varied widely among patients in each study phase with a median of -89.5, -76.8 and -3 mmol using d[Ca] 1.25 mmol/L, -106, -26.8 and 29.7 mmol using d[Ca] 1.50 mmol/L, and 12.8, -14.5 and 38 mmol using d[Ca] 1.75 mmol/L during pre-PTX, early post-PTX and late post-PTX, respectively, which was significantly different among d[Ca] (p = 0.0001) and among phases (p = 0.040). Ca gradient and delta of Ca also differed among d [Ca] and phases (p<0.05 for all comparisons), whether ultrafiltration was similar. Serum Osteocalcin decreased significantly in late post-PTX, whereas Sclerostin increased earlier, in early post-PTX. Conclusions The skeleton plays a key role in Ca mass transfer during dialysis, either by determining pre-dialysis serum Ca or by controlling the exchangeable Ca pool. Knowing that could help us to decide which d[Ca] should be chosen in a given patient.
dc.description.indexMEDLINE
dc.description.sponsorshipCNPQ, Conselho Nacional de Desenvolvimento Cientifico e Tecnologico [304249/2013-0, 303899/2016-6]
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo [2010/20549-9]
dc.identifier.citationPLOS ONE, v.13, n.7, article ID e0198946, 14p, 2018
dc.identifier.doi10.1371/journal.pone.0198946
dc.identifier.issn1932-6203
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/28331
dc.language.isoeng
dc.publisherPUBLIC LIBRARY SCIENCE
dc.relation.ispartofPlos One
dc.rightsopenAccess
dc.rights.holderCopyright PUBLIC LIBRARY SCIENCE
dc.subject.otherchronic kidney-disease
dc.subject.otherlong-frequent hemodialysis
dc.subject.otheradynamic bone-disease
dc.subject.otherdialysate calcium
dc.subject.otherbicarbonate hemodialysis
dc.subject.othermineral metabolism
dc.subject.otherbalance
dc.subject.otherhemodiafiltration
dc.subject.otherguideline
dc.subject.otherremoval
dc.subject.wosMultidisciplinary Sciences
dc.titleA prospective study of the influence of the skeleton on calcium mass transfer during hemodialysis
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalANTUNES, Gisele Lins:Univ Sao Paulo, Nephrol Div, Sao Paulo, Brazil
hcfmusp.author.externalMOE, Sharon:Indiana Univ Sch Med, Indianapolis, IN 46202 USA; Richard L Roudebush Vet Adm Med Ctr, Indianapolis, IN USA
hcfmusp.citation.scopus6
hcfmusp.contributor.author-fmusphcPATRICIA TASCHNER GOLDENSTEIN
hcfmusp.contributor.author-fmusphcFABIANA GIORGETI GRACIOLLI
hcfmusp.contributor.author-fmusphcWAGNER VASQUES DOMINGUEZ
hcfmusp.contributor.author-fmusphcLUCIENE MACHADO DOS REIS
hcfmusp.contributor.author-fmusphcROSILENE MOTTA ELIAS
hcfmusp.contributor.author-fmusphcVANDA JORGETTI
hcfmusp.contributor.author-fmusphcROSA MARIA AFFONSO MOYSES
hcfmusp.description.articlenumbere0198946
hcfmusp.description.issue7
hcfmusp.description.volume13
hcfmusp.origemWOS
hcfmusp.origem.pubmed30059531
hcfmusp.origem.scopus2-s2.0-85050865351
hcfmusp.origem.wosWOS:000440251600004
hcfmusp.publisher.citySAN FRANCISCO
hcfmusp.publisher.countryUSA
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