Abstract:
BACKGROUND:Calcium (Ca) is an essential element that plays a critical role in many biological processes. In dialysis patients, the regulation of Ca balance is highly complex, given the absence of kidney function, endocrine disturbances and the use of drugs such as phosphate binders, vitamin D analogues, and calcimimetics. Also, the use of different dialysate Ca (DCa) baths has profound effect on Ca balance, which depends both on the difference between the Ca concentration in the bath and the serum of the patients, as on the ultrafiltration volume. SUMMARY:The choice of DCa may have important short- and long-term consequences. While lower DCa (especially < 2.5 mEq/L) concentrations have been associated with an increased risk of sudden cardiac death in observational studies, DCa in the higher ranges (3.0 mEq/L and above) may contribute to vascular pathology. Intra-dialytic hemodynamics may also be affected by the choice of DCa. In general, lower DCa concentrations are associated with an increase, and higher DCa concentrations with a decrease in parathyroid hormone (PTH) levels. Preliminary data has suggested that a DCa of 2.75 mEq/L may help in obtaining a net zero intradialytic Ca balance in individual patients, but clinical experience is still limited. Key Message: The optimal Ca balance depends on multiple parameters including blood Ca levels, PTH and the use of phosphate binders and vitamin D analogues, as well as on the risk of hemodynamic stability and cardiac arrhythmias. Therefore, DCa prescription should be individualised. A DCa of 2.75 mEq/L may be useful adjunct for dialysis providers.
journal_name
Blood Purifjournal_title
Blood purificationauthors
van der Sande FM,Ter Meulen KJA,Kotanko P,Kooman JPdoi
10.1159/000494584subject
Has Abstractpub_date
2019-01-01 00:00:00pages
230-235issue
1-3eissn
0253-5068issn
1421-9735pii
000494584journal_volume
47pub_type
杂志文章,评审abstract::The EUPHRATES trial (Evaluating Use of Polymyxin B Hemoperfusion in a Randomized Controlled Trial of Adults Treated for Endotoxemia and Septic Shock) is the first biomarker-driven trial in sepsis. This unique trial is being run in a blinded manner, further contributing to the robustness of its design. This paper will ...
journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000356832
更新日期:2014-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000014384
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journal_title:Blood purification
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journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000067869
更新日期:2003-01-01 00:00:00
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journal_title:Blood purification
pub_type: 社论
doi:10.1159/000476012
更新日期:2017-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
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journal_title:Blood purification
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Blood purification
pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1159/000046996
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journal_title:Blood purification
pub_type: 临床试验,杂志文章
doi:10.1159/000348456
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journal_title:Blood purification
pub_type: 临床试验,杂志文章
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更新日期:2003-01-01 00:00:00
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journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1159/000492919
更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000170236
更新日期:1996-01-01 00:00:00
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journal_title:Blood purification
pub_type: 社论
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更新日期:2018-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
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更新日期:1998-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000496660
更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000218090
更新日期:2009-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2021-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000266483
更新日期:2010-01-01 00:00:00
abstract::The effects of pulsatile perfusion on microcirculation and renal function in high-risk patients were evaluated in this study. Pulsatile roller pumps with a pulsatile control module and membrane oxygenator were used in a clinical setting. 40 patients undergoing elective cardiac surgery with a high risk of either having...
journal_title:Blood purification
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-01-01 00:00:00
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journal_title:Blood purification
pub_type: 临床试验,杂志文章
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journal_title:Blood purification
pub_type: 杂志文章,评审
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更新日期:2018-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000496641
更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2013-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000078699
更新日期:2004-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000381006
更新日期:2015-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章
doi:10.1159/000501512
更新日期:2019-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
doi:10.1159/000157325
更新日期:2008-01-01 00:00:00
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journal_title:Blood purification
pub_type: 杂志文章,评审
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