Wang Cheng, Lou Tan-Qi, Chen Zhu-Jiang, Tang Hua, Shi Cheng-Gang, Yu Xue-Qing, Yin Pei-da
Department of Nephrology, The Third Hospital Affiliated to Sun Yat-sen University, Guangzhou, Guangdong, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2007 Apr;19(4):236-8.
To investigate the changes in blood pressure in hemodialysis patients treated with low calcium dialysate or high calcium dialysate for long time.
Fifteen patients undergoing hemodialysis were enrolled in this study. High calcium dialysate (1.75 mmol/L, Dca1.75) was first used for 6 months, then low calcium dialysate (1.25 mmol/L, Dca1.25) was used for 6 months. Serum calcium, phosphate, blood urea nitrogen, and creatinine were measured, blood pressure was recorded before and after hemodialysis at the beginning, and also at 1, 2, 3 and 4 hours after hemodialysis.
Compared with that before the treatment, systolic and diastolic blood pressure lowered significantly after single low calcium hemodialysis for 4 hours (both P<0.05), while systolic and diastolic blood pressure rose significantly after single high calcium hemodialysis (both P<0.05). Systolic blood pressure changed more obviously after two hemodialyses (both P<0.05). Changes in systolic, diastolic and mean blood pressure were positively related to changes in serum total calcium (r(1)=0.326, P(1)=0.054; r(2)=0.383, P(2)=0.037; r(3)=0.391, P(3)=0.032). During 6 months of hemodialysis with low calcium dialysate, blood pressure lowered slightly with no significant difference in it (P>0.05), while systolic blood pressure rose during 6 months of hemodialysis with high calcium dialysate (P<0.05). Changes in systolic blood pressure were significantly different between two groups using dialysates with different calcium concentrations (P<0.05).
Systolic blood pressure and incidence of hypertension decrease after single low calcium hemodialysis.
探讨长期使用低钙透析液或高钙透析液治疗的血液透析患者血压的变化情况。
本研究纳入15例接受血液透析的患者。首先使用高钙透析液（1.75 mmol/L，Dca1.75）6个月，然后使用低钙透析液（1.25 mmol/L，Dca1.25）6个月。检测血清钙、磷、血尿素氮和肌酐，在开始时以及血液透析后1、2、3和4小时记录血液透析前后的血压。
与治疗前相比，单次低钙血液透析4小时后收缩压和舒张压显著降低（均P<0.05），而单次高钙血液透析后收缩压和舒张压显著升高（均P<0.05）。两次血液透析后收缩压变化更明显（均P<0.05）。收缩压、舒张压和平均血压的变化与血清总钙的变化呈正相关（r(1)=0.326，P(1)=0.054；r(2)=0.383，P(2)=0.037；r(3)=0.391，P(3)=0.032）。在使用低钙透析液进行6个月血液透析期间，血压略有下降，差异无统计学意义（P>0.05），而在使用高钙透析液进行6个月血液透析期间收缩压升高（P<0.05）。使用不同钙浓度透析液的两组间收缩压变化差异有统计学意义（P<0.05）。
单次低钙血液透析后收缩压及高血压发生率降低。
