Calcium balance and intact PTH variations during haemodiafiltration.

Abstract

Recent approaches to prevent and treat secondary hyperparathyroidism in dialysis patients include decreasing dialysate Ca content from 1.75 to 1.5 mM or lower. We have recently observed that by decreasing dialysate Ca to 1.25 mM a rise in intact parathormone serum levels occurs despite adequately controlled predialysis Ca and phosphate serum levels. In that study complementary treatment with high-dose 1 alpha(OH) vitamin D3 was required to suppress the parathormone. In the present study we aimed to assess the total Ca balance as well as the modifications in parathormone induced by the dialysis session in order to understand the reasons for which the rise in parathormone was induced.