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      Exchange of Alkali Trace Elements in Hemodialysis Patients:A Comparison with Na + and K +

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          Abstract

          Background: In the past, nephrologists have been troubled by electrolyte disturbances and consequently focused their attention on the importance of maintaining the concentrations of electrolytes within the normal range. However, information about the potential role of trace elements in chronic renal failure is scarce. Methods: During hemodialysis sessions, the concentrations of the five alkali metal cations lithium (Li), sodium (Na), potassium (K), rubidium (Rb), and cesium (Cs) have been determined in plasma and dialysis fluids of chronic hemodialysis patients by inductively coupled plasma mass spectrometry (Li, Rb, Cs) and by ion-sensitive electrodes (Na, K). Strict quality control schemes were applied to all analytical procedures to ensure accuracy and precision of the results. Results: The plasma concentrations of the elements Li, Cs, Rb, and K distinctly decreased to 29, 50, 69, and 71%, respectively, of their initial values during hemodialysis. Simultaneously, the concentrations of these elements in dialysis fluids at the outlet of the dialyzer increased approximately 13-fold for Rb, 11-fold for Li, 3-fold for Cs, and 2-fold for K as compared with the inlet values. The concentrations of Na in plasma and dialysis fluids were almost identical and did not change during hemodialysis. Conclusions: Li, Rb, and Cs were depleted in hemodialysis patients, although the plasma concentrations of these trace elements still remained within the reference ranges for healthy adults. Consequently, further studies are needed to elucidate the clinical importance and long-term effects of these trace element imbalances – for example, CNS disturbances associated with diminished concentrations of Rb – in hemodialysis patients.

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          Trace element reference values in tissues from inhabitants of the European community I. A study of 46 elements in urine, blood and serum of Italian subjects

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            Certification of a second-generation biological reference material (freeze-dried human serum) for trace element determinations

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              Author and article information

              Journal
              NEF
              Nephron
              10.1159/issn.1660-8151
              Nephron
              S. Karger AG
              1660-8151
              2235-3186
              1999
              November 1999
              13 October 1999
              : 83
              : 3
              : 226-236
              Affiliations
              aInstitute of Analytical Chemistry and bDepartment of Internal Medicine, Medical School, Karl Franzens University, Graz, cInstitute of Biomedical Engineering, Technical University, Graz, Austria
              Article
              45515 Nephron 1999;83:226–236
              10.1159/000045515
              10529629
              © 1999 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Figures: 2, Tables: 5, References: 45, Pages: 11
              Product
              Self URI (application/pdf): https://www.karger.com/Article/Pdf/45515
              Categories
              Original Paper

              Cardiovascular Medicine, Nephrology

              Plasma, Dialysis fluids, Lithium, Sodium, Cesium, Potassium, Rubidium, Hemodialysis

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