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Titolo:
INFLUENCE OF CHANGES IN IONIZED CALCIUM ON CARDIOVASCULAR REACTIVITY DURING HEMODIALYSIS
Autore:
VANKUIJK WHM; MULDER AW; PEELS CH; HARFF GA; LEUNISSEN KML;
Indirizzi:
CATHARINA HOSP,DEPT INTERNAL MED,POB 1350 NL-5602 ZA EINDHOVEN NETHERLANDS CATHARINA HOSP,DEPT CARDIOL NL-5602 ZA EINDHOVEN NETHERLANDS CATHARINA HOSP,DEPT CLIN CHEM NL-5602 ZA EINDHOVEN NETHERLANDS UNIV HOSP MAASTRICHT,DEPT INTERNAL MED MAASTRICHT NETHERLANDS
Titolo Testata:
Clinical nephrology
fascicolo: 3, volume: 47, anno: 1997,
pagine: 190 - 196
SICI:
0301-0430(1997)47:3<190:IOCIIC>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR CONTRACTILITY; CARDIAC-OUTPUT; BLOOD-PRESSURE; DOPPLER ECHOCARDIOGRAPHY; DIALYSATE; VOLUME;
Keywords:
IONIZED CALCIUM; ARTERIAL BLOOD PRESSURE; FOREARM VASCULAR RESISTANCE AND VENOUS TONE; MYOCARDIAL CONTRACTILITY; HEMODIALYSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
27
Recensione:
Indirizzi per estratti:
Citazione:
W.H.M. Vankuijk et al., "INFLUENCE OF CHANGES IN IONIZED CALCIUM ON CARDIOVASCULAR REACTIVITY DURING HEMODIALYSIS", Clinical nephrology, 47(3), 1997, pp. 190-196

Abstract

In order to prevent hypercalcemia due to the treatment of secondary hyperparathyroidism the use of low calcium dialysate is advocated. However, as calcium ions play a pivotal role in both myocardial and vascular smooth muscle contraction, lowering the dialysate calcium concentration might result in a further impairment of the cardiovascular response during dialysis. Therefore, arterial blood pressure, forearm vascular resistance (FVR) and venous tone (VT) (straing-gauge plethysmography) as well as cardiac dimensions and output (echocardiography) were measured in IO hemodynamically stable dialysis patients (ejection fraction >30%) during two standardized sessions of three-hour combined ultrafiltration-hemodialysis (UF+HD) at two different dialysate calcium concentrations: 1.25 and 1.75 mmol/l. High calcium UF+HD resulted in a significant increase in plasma ionized calcium (+0.19 +/- 0.11 mmol/l; p<0.01) while ionized calcium remained unchanged during low calcium UFHD (-0.02 +/- 0.07 mmol/l). As a result, systolic, diastolic and meanarterial blood pressure were respectively 14 +/- 10, 5 +/- 7 and 9 +/- 9 mmHg higher during high calcium UF+HD as compared to low calcium UF+HD (p <0.05). There were no significant differences in FVR and VT between the two treatments. During both treatments FVR increased while VT decreased. In addition, there were no differences in calculated systemic vascular resistance. However, with comparable end-diastolic dimensions, stroke volume (-18 +/- 13 mi) and cardiac output (-1.3 +/- 1.5 l/min) decreased significantly (p <0.05) only during low calcium UF+HD. We conclude that even in hemodynamically stable patients changes in plasma ionized calcium are an important determinant of the blood pressure response during dialysis therapy. Whereas peripheral vascular reactivity is unaffected by changes in ionized calcium, myocardial contractility is improved with higher dialysate calcium concentrations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 19:47:35