Blood Pressure Response to Changes in Serum Ionized Calcium During Hemodialysis

  1. JOHN C. MAYNARD, M.D.;
  2. COSME CRUZ, M.D.;
  3. MICHAEL KLEEREKOPER, M.D.; and
  4. NATHAN W. LEVIN, M.D.
  1. Detroit, Michigan

    Abstract

    The effect of an increasing serum ionized calcium concentration on blood pressure during hemodialysis was studied in a prospective cross-over trial. Twelve patients were dialyzed three times with a dialysate Ca concentration of 5.5 mg/dL and three times with one of 7.5 mg/dL. Dialysis with the high Ca dialysate was associated with less fall in the mean arterial pressure (p < 0.001). No statistically significant changes occurred in serum osmolality, body weight, or heart rate after dialysis at the two dialysate Ca levels. Increasing the Ca concentration in dialysate may protect against intradialytic hypotension in some patients.

    Article and Author Information

    • ▸From the Divisions of Nephrology and Hypertension and of Mineral Metabolism, Department of Internal Medicine, Henry Ford Hospital; Detroit, Michigan.

    • ▸Requests for reprints should be addressed to Cosme Cruz, M.D.; Division of Nephrology, Henry Ford Hospital, 2799 W. Grand Boulevard; Detroit, MI 48202.

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    1. Ann Intern Med March 1, 1986 vol. 104 no. 3 358-361
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