KINETIC OF CALCIUM, PHOSPHATE, MAGNESIUM AND PTH VARIATIONS DURING HEMODIAFILTRATION.
CINETICA DEL CALCIO, FÓSFORO, MAGNESIO Y VARIACIONES DE LA PARATHORMONA (PTH) EN PACIENTES EN HEMODIAFILTRACION
Asunción Ríus Peris, Julio Hernández-Jaras, Ramón Pons Prades, Héctor García Pérez, Eduardo Torregrosa de Juan, Juan José Sánchez Canel
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MAGNESIUM AND PTH VARIATIONS DURING HEMODIAFILTRATION." "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "593" "paginaFinal" => "598" ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Asunción Ríus Peris, Julio Hernández-Jaras, Ramón Pons Prades, Héctor García Pérez, Eduardo Torregrosa de Juan, Juan José Sánchez Canel" "autores" => array:1 [ 0 => array:1 [ "nombre" => "Asunción Ríus Peris, Julio Hernández-Jaras, Ramón Pons Prades, Héctor García Pérez, Eduardo Torregrosa de Juan, Juan José Sánchez Canel" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "CINETICA DEL CALCIO, FÓSFORO, MAGNESIO Y VARIACIONES DE LA PARATHORMONA (PTH) EN PACIENTES EN HEMODIAFILTRACION" ] ] "pdfFichero" => "P-E-S-A4756-EN.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec436185" "palabras" => array:1 [ 0 => "Hemodiafiltración, balance de calcio, PTH, calcio iónico, fósforo, magnesio" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec436186" "palabras" => array:1 [ 0 => "Hemodiafiltration, calcium balance, parathyroid hormone, ionized calcium, phosphate, magnesium" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "Hemodiafiltration (HDF) is a technique resulting from coupling of diffusive and convective transport and thereby increase the elimination of small and middle molecules. However, may induce a convective loss from others substances such as calcium and magnesium. The aim of this study was to evaluate the effects of Ultrafiltration on the kinetics of calcium, phosphate, magnesium and parathyroid hormone. A total of thirteen patients (7 males and 6 females) on hemodialysis, were studied. Each patient was randomly dialyzed with the same dialysate calcium concentration and three different ultrafiltration rate. Schedule A: High flux hemodialysis, schedule B: HDF with 10% of weight body and schedule C: HDF with 20% of weight body. The others parameters were kept identical. Total Ultrafiltration was 2,6±0,9 L (9,78±3,78 ml/min) in A, 9,3±1,7 L (34,54±6,22 ml/min) in B and 16,3±3,3 L (60,94±12,63 ml/min) in C. Replacement fluid during dialysis was 6,85±1,42 and 13,65±2,9 L. in C and C respectively. Posdialysis total,ionized calcium and magnesium were significantly lower in schedules B and C versus A. PTH levels did not differ significantly. However, PTH changes during dialysis was -36.6±38.6%, 6.3±69.8% and 32.2±63.2% in A, B and C, respectively (p <0 05 a vs c significant inverse correlation was found between total ultrafiltration and posdialysis levels of calcium r:-0 56 p <0 001 ionized calcium r:-0 65 p <0 001 and magnesium r:-0 47 p <0 01 no differences were observed in pre and posdialysis phosphate levels neither mass transfer clearance of we concluded that high ultrafiltration flow rates substitution fluid without divalent cations induces a negative calcium magnesium balance these changes may stimulate pth secretion during hdf this technique did not resulte higher or removal</0> </0> </0> </0>" ] "es" => array:1 [ "resumen" => "La hemodiafiltración (HDF) es una técnica que combina los mecanismos difusivo y convectivo para lograr mayor eficacia depurativa. La confluencia de ambos mecanismos puede dificultar la transferencia de sustancias como el calcio, cuyo gradiente difusivo sea líquido de diálisis-sangre. El objetivo de nuestro estudio fue valorar la importancia de la convección en la transferencias del calcio, fósforo, magnesio y la PTH. Se estudiaron 13 pacientes en programa de hemodiálisis. A cada paciente se le realizó en la sesión de mitad de semana y de manera aleatoria tres esquemas de hemodiálisis: Tipo A.: Hemodiálisis de alto flujo. Tipo B:HDF del 10% del peso seco. Tipo C:HDF del 20% del pesoseco. Las características de la sesión de HD fueron las habituales en cada paciente. La concentración de calcio en el líquido de diálisis fue la misma en los 3 tipos de sesiones. La composición del líquido de sustitución era: Na 145 mEq/l, Cl 85 mEq/l, HCO3-60mEq/l. El monitor de hemodiálisis empleado fue Integra® que disponía del módulo Quantiscan. Se determinaron al inicio (pre-HD) y al final (pos-HD) de la diálisis, el calcio total, calcio iónico, fósforo, magnesio y PTH. En el líquido de diálisis recogido mediante el Quantiscan, se determinaron los niveles de fósforo.No encontramos diferencias significativas entre los tres tipos de sesión para las concentraciones de calcio total pre-HD, Ca++ pre-HD, Mg pre-HD, fósforo pre y pos-HD ni en la transferencia de masa de fósforo. El calcio total pos-HD fue 9,93 ± 0,75 en la sesión A, 9,30 ± 0,79 en la B y 8,79 ± 0,69 mg/dl en la C (p < 0,01 A vs B y C). El Ca++ pos-HD fue de 2,61 ± 0,25 en la sesión A, 2,36 ± 0,27 en la B y 2,13 ± 0,28 mEq/l. en la C. (p < 0,01 A vs C). El Mg pos-HD 2,04 ± 0,11, 1,78 ± 0,14 y 1,77 ± 0,22 mg/dl, respectivamente (p < 0,001 A vs B y C). No se evidenciaron diferencias significativas en la PTH pre ni pos-HD. El porcentaje de variación de PTH durante la sesión fue de -36,6 ± 38,6% en la A, 6,3 ± 69,8% en la B y 32,2 ± 63,2% en la tipo C (p < 0,05 A vs C). La ultrafiltración total se correlacionó de manera inversa con los niveles séricos pos-HD, tanto de Ca total (r: -0,56, p < 0,001), Ca++ (r: -0,65, p < 0,001), como Mg (-0,47, p < 0,01). Concluimos que el incremento en las tasas de ultrafiltración con líquidos de sustitución carentes de cationes divalentes, originan un balance de calcio y magnesio negativo con descenso en los niveles séricos de estos cationes al final de la sesión. Estos cambios pueden provocar un incremento en los niveles de PTH.No hemos apreciado mejoría en las transferencias de masa de fósforo ni en su aclaramiento al aumentar la tasa de ultrafiltración." ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002700000005/v0_201502091551/X2013251407021872/v0_201502091551/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002700000005/v0_201502091551/X2013251407021872/v0_201502091551/en/P-E-S-A4756-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251407021872?idApp=UINPBA000064" ]
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