Theme |
Blood Purification Solution |
Title |
Evaluation of the possibilities of increased medication with vitaminD3 and CaCO3 for dialysates of lower Ca and bicarbonate concentration |
Author |
Youichi Okada |
Divisions of Nephrology, Maruko Central General Hospital |
Author |
Kazuhiko Yamada |
Divisions of Nephrology, Maruko Central General Hospital |
Author |
Daiji Maruyama |
Internal Medicine, Maruko Central General Hospital |
[ Summary ] |
It is very difficult to suppress progressive secondary hyperparathyroidism in hemodialysis patients. Therefore, we compared the possibilities of increased medication with vitaminD3 and CaCO3, using dialysates with three different components (DD25 : Ca 2.5mEq/dl, HCO3 25mEq/l, DD30 : Ca 3.0mEq/dl, HCO3 25mEq/l, AF-2 solution : Ca 3.0mEq/dl, HCO3 30mEq/l). As a result, using DD25, we significantly increased medication using vitaminD3 and CaCO3 in comparison to DD30 and AF-2 solutions. But we could not determine a significant reduction in PTH-C compared to other dialysates. Next, we examined the relationship of S-Ca values to dialysate bicarbonate concentrations and DD30 and AF-2 solutions. As a result, it was shown that lower bicarbonate dialysate levels suppressed an increase in S-Ca values. These findings indicated that lower Ca and lower bicarbonate dialysate levels suppressed the increase of S-Ca values. We believe that lower Ca and bicarbonate dialysate levels were useful in treatment of secondary hyper parathyroidism. |