Rudnicki M, Frølich A, Haaber A, Tvedegaard E, Thode J
Department of Nephrology, Herlev Hospital, University of Copenhagen, Denmark.
Clin Nephrol. 1993 Oct;40(4):225-9.
The serum concentrations of actual ionized calcium (at actual pH), adjusted ionized calcium (at pH 7.4), pH, intact parathyroid hormone (PTH) and phosphate were studied in ten patients during and between two hemodialysis sessions using a dialysate containing 1.66 mmol/l of calcium. Actual ionized calcium and adjusted ionized calcium increased during hemodialysis from 1.19 to 1.38 and 1.43 mmol/l, respectively (mean values) and returned to predialysis values within five and nine hours postdialysis. Serum PTH decreased from 165 ng/l to 55 ng/l (median values) during hemodialysis but two-hour postdialysis the level did not differ significantly from the predialysis level. Serum phosphate decreased from 2.05 mmol/l to 1.11 mmol/l during hemodialysis, and increased slowly towards the predialysis level. The level of pH increased from 7.40 to 7.47 during hemodialysis and reached predialysis level after nine hours. In a multivariate analysis including actual and adjusted ionized calcium, pH, phosphate and PTH, only actual or adjusted ionized calcium was associated with the level of PTH. We conclude that the effect of dialysate calcium on the levels of ionized calcium and PTH is of very short duration postdialysis.
在十名患者进行两次血液透析期间及透析间隔期，使用含钙1.66 mmol/l的透析液，研究了实际离子钙（在实际pH值下）、校正离子钙（在pH 7.4下）、pH值、完整甲状旁腺激素（PTH）和磷酸盐的血清浓度。血液透析期间，实际离子钙和校正离子钙分别从1.19 mmol/l升至1.38 mmol/l和1.43 mmol/l（平均值），并在透析后5小时和9小时内恢复到透析前水平。血液透析期间，血清PTH从165 ng/l降至55 ng/l（中位数），但透析后两小时，该水平与透析前水平无显著差异。血液透析期间，血清磷酸盐从2.05 mmol/l降至1.11 mmol/l，并缓慢回升至透析前水平。血液透析期间，pH值从7.40升至7.47，9小时后恢复到透析前水平。在一项包括实际离子钙和校正离子钙、pH值、磷酸盐和PTH的多变量分析中，只有实际或校正离子钙与PTH水平相关。我们得出结论，透析液钙对离子钙和PTH水平的影响在透析后持续时间非常短。
