Effects of low dialysate calcium concentration on health-related quality of life in hemodialysis patients.

BACKGROUND

A dialysate calcium concentration of 2.5 meq/l (1.25 mmol/l) is currently recommended, but there are not enough studies to examine the effects of this calcium concentration on clinical outcomes. We explored the effects of this calcium concentration on health-related quality of life (HRQOL) in hemodialysis patients.

METHODS

The dialysate calcium concentration was lowered from 3.0 meq/l to 2.5 meq/l in 78 hemodialysis patients. The Medical Outcomes Study (MOS) Short Form 36 (SF-36) norm-based scores, the doses of recombinant human erythropoietin (rHuEpo), and the serum levels of corrected calcium, phosphorus, intact parathyroid hormone (i-PTH), and hemoglobin were compared at baseline and 8 months after the change of dialysate calcium concentration.

RESULTS

Seventy-three patients completed the study. Mean changes in SF-36 scores were: physical functioning, -2.4; role physical, -3.9; bodily pain, -3.4; general health perception, -1.5; vitality, -2.2; social functioning, -1.9; role emotional, -2.0; mental health, -2.0. The declines of scores for role physical and bodily pain were significant. Serum i-PTH levels increased significantly, from 212 pg/ml to 278 pg/ml, while the doses of rHuEpo and serum levels of corrected calcium, phosphorus, and hemoglobin did not change significantly.

CONCLUSIONS

A dialysate calcium concentration of 2.5 meq/l was not shown to have positive effects on HRQOL.