Hemodialysis and hemodiafiltration-induced transient hypercalcemia: an unrecognized phenomenon with potential for calcium-loss and vascular calcification

  • Kamel El-Reshaid Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
  • Shaikha Al-Bader Department of Medicine, Nephrology unit, Amiri hospital, Ministry of health, Kuwait
  • Salah El-Marzabani Edelia dialysis center, Ministry of health, Kuwait
  • Ehab Ahmad Department of Medicine, Nephrology unit, Amiri hospital, Ministry of health, Kuwait

Abstract

Uremic vascular calcification is prevalent in 70-80% of end-stage kidney disease (ESRD) patients and is an independent predictor of cardiovascular morbidity and mortality.  In this study we report our experience with significant transient hypercalcemia during maintenance hemodialysis (HD) in 105 patients and hemodiafiltration (HDF) in another 44 ones. The studied patients had controlled predialysis levels of calcium, phosphorus, 1, 25 vitamin D and parathyroid hormone.  Treatment was associated with high dialysate calcium and low serum phosphorus without significant changes in parathyroid hormone levels.  Pre-treatment with a single dose of Fosamax; resulted in amelioration of hypercalcemia indicating its bone etiology.  In conclusion; maintenance HD and HDF are associated with inherent hypercalcemia which may contribute to osteomalacia and uremic vascular calcification in ESRD patients. 


Keywords: Bisphosphonates, HD, HDF, hypercalcemia, hypophosphatemia, osteomalacia, vascular calcification, uremia.

Keywords: Bisphosphonates, HD, HDF, hypercalcemia, hypophosphatemia, osteomalacia, vascular calcification, uremia

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Author Biographies

Kamel El-Reshaid, Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

Shaikha Al-Bader, Department of Medicine, Nephrology unit, Amiri hospital, Ministry of health, Kuwait

Department of Medicine, Nephrology unit, Amiri hospital, Ministry of health, Kuwait

Salah El-Marzabani, Edelia dialysis center, Ministry of health, Kuwait

Edelia dialysis center, Ministry of health, Kuwait

Ehab Ahmad, Department of Medicine, Nephrology unit, Amiri hospital, Ministry of health, Kuwait

Department of Medicine, Nephrology unit, Amiri hospital, Ministry of health, Kuwait

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El-Reshaid K, Al-Bader S, El-Marzabani S, Ahmad E. Hemodialysis and hemodiafiltration-induced transient hypercalcemia: an unrecognized phenomenon with potential for calcium-loss and vascular calcification. JDDT [Internet]. 15May2021 [cited 18Jun.2021];11(3):58-0. Available from: https://jddtonline.info/index.php/jddt/article/view/4779

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