Blood calcium balance and dialysate calcium concentration in heamodialysis patients in Thi-Qar province, Iraq

الملخص EN

Objective: This study designed to assess whether dialysate calcium concentration is adequate to maintain blood calcium balance in patients receiving hemodialysis therapy or not adequate.

Patients and Methods: We evaluated 170 patients undergoing chronic kidney disease in dialysis unit at AL- Hussein teaching hospital in Thi - Qar province.

Results: The 170 patient included 70 (30%) were female and 100 (70 %) were male, aged from 19 to 90 years, the duration of dialysis session 3hour per day, number of dialysis session per week was two time per week for all heamodialysis patients, and dialysate calcium concentration was 1.75 mmol/L.

Results show normal calcemia in pre and post dialysis session in 30 patients (17.65%) their serum calcium was within normal range 2.24 - 2.5 mmol/L with no significant change (p > 0.05), and 48 (28.24%) show changes in serum calcium from 1.75 ± 0.11in pre to 2.32 ± 0.24 mmol/L in post HD session with no significant changes (p > 0.05), but 92 ( 54.24%) patients were diagnosed with hypocalcemia in pre 1.48 ± 0.16 and post 1.72 ± 0.20 dialysis session also with no significant change (p > 0.05).

Conclusions: the concentration of dialysate calcium 1.75 mmol/l (3.5 mEq/L) was adequate and frequently used with the aim of obtaining positive blood calcium balance especially in patients with normal ( [Ca ] < 2.40 mmol/L) or Pre hypocalcaemia ( *Ca+ ≥ 1.75 mmol/L).

But in patients with severe degree pre - hypocalcemia ( *Ca + ≤ 1.48 mmol/l) dialysate Ca concentration (1.75 mmol/L) should be increased by ~ 0.25 mmol/L to maintain comparable balances as possible as or treated with calcium gluconate (10 % w/v) injection ampoule 10 ml (1ml ≈ 0.23 mmol/L) after HD session.