Blood calcium balance and dialysate calcium concentration in heamodialysis patients in Thi- Qar Province, Iraq

  • Zainab Ali Kadhem MSc. Biochemistry (Lecturer), Department of Medical Chemistry, College of Medicine, Thi- Qar University, Iraq
Keywords: Blood calcium balance, heamodialysis, dialysate calcium concentration


Objective: This study designed to assess whether dialysate calcium concentration is adequate to maintain blood calcium balance in patients receiving hemodialysis therapy or not adequate. Patients and Methods:  We evaluated 170 patients undergoing chronic kidney disease in dialysis unit at AL- Hussein teaching hospital in Thi - Qar province. Results:  The 170 patient included  70 (30%) were female and   100 (70 %)  were  male, aged from 19 to  90  years,  the duration of dialysis session  3hour per day,  number of dialysis session per week  was two time per week for all heamodialysis patients, and  dialysate calcium concentration was 1.75 mmol/L. Results show normal calcemia in pre and post dialysis session in 30 patients  (17.65%) their serum calcium  was within normal range 2.24 - 2.5 mmol/L with no significant change (p > 0.05), and  48  (28.24%)  show changes in serum calcium  from 1.75 ±  0.11in pre to 2.32 ±  0.24 mmol/L  in post HD session  with no significant changes (p > 0.05),  but  92 ( 54.24%) patients were diagnosed with hypocalcemia in pre  1.48 ± 0.16 and post 1.72 ±  0.20 dialysis session also with no significant change (p > 0.05). Conclusions: the concentration of dialysate calcium 1.75 mmol/l (3.5 mEq/L) was adequate and   frequently used with the aim of obtaining positive blood calcium balance especially in patients with normal ( [Ca ] < 2.40 mmol/L) or Pre  hypocalcaemia ( [Ca]  ≥ 1.75  mmol/L). But in  patients with  severe degree  pre - hypocalcemia ( [Ca ] ≤ 1.48 mmol/l) dialysate Ca concentration (1.75 mmol/L) should be increased by ~ 0.25 mmol/L to maintain comparable balances as possible as  or treated  with calcium gluconate (10 % w/v) injection ampoule 10 ml  (1ml ≈ 0.23 mmol/L) after HD session.


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