Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis

Detalhes bibliográficos
Autor(a) principal: Elias,Rosilene M.
Data de Publicação: 2021
Outros Autores: Moe,Sharon, Moysés,Rosa M. A
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000400539
Resumo: Abstract Patients on hemodialysis are exposed to calcium via the dialysate at least three times a week. Changes in serum calcium vary according to calcium mass transfer during dialysis, which is dependent on the gradient between serum and dialysate calcium concentration (d[Ca]) and the skeleton turnover status that alters the ability of bone to incorporate calcium. Although underappreciated, the d[Ca] can potentially cause positive calcium balance that leads to systemic organ damage, including associations with mortality, myocardial dysfunction, hemodynamic tolerability, vascular calcification, and arrhythmias. The pathophysiology of these adverse effects includes serum calcium changes, parathyroid hormone suppression, and vascular calcification through indirect and direct effects. Some organs are more susceptible to alterations in calcium homeostasis. In this review, we discuss the existing data and potential mechanisms linking the d[Ca] to calcium balance with consequent dysfunction of the skeleton, myocardium, and arteries.
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spelling Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysisChronic Kidney Disease-Mineral and Bone DisorderParathyroidCalcium Transfer MassVesselsMyocardiumAbstract Patients on hemodialysis are exposed to calcium via the dialysate at least three times a week. Changes in serum calcium vary according to calcium mass transfer during dialysis, which is dependent on the gradient between serum and dialysate calcium concentration (d[Ca]) and the skeleton turnover status that alters the ability of bone to incorporate calcium. Although underappreciated, the d[Ca] can potentially cause positive calcium balance that leads to systemic organ damage, including associations with mortality, myocardial dysfunction, hemodynamic tolerability, vascular calcification, and arrhythmias. The pathophysiology of these adverse effects includes serum calcium changes, parathyroid hormone suppression, and vascular calcification through indirect and direct effects. Some organs are more susceptible to alterations in calcium homeostasis. In this review, we discuss the existing data and potential mechanisms linking the d[Ca] to calcium balance with consequent dysfunction of the skeleton, myocardium, and arteries.Sociedade Brasileira de Nefrologia2021-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000400539Brazilian Journal of Nephrology v.43 n.4 2021reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.1590/2175-8239-jbn-2020-0098info:eu-repo/semantics/openAccessElias,Rosilene M.Moe,SharonMoysés,Rosa M. Aeng2021-12-06T00:00:00Zoai:scielo:S0101-28002021000400539Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2021-12-06T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
title Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
spellingShingle Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
Elias,Rosilene M.
Chronic Kidney Disease-Mineral and Bone Disorder
Parathyroid
Calcium Transfer Mass
Vessels
Myocardium
title_short Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
title_full Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
title_fullStr Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
title_full_unstemmed Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
title_sort Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
author Elias,Rosilene M.
author_facet Elias,Rosilene M.
Moe,Sharon
Moysés,Rosa M. A
author_role author
author2 Moe,Sharon
Moysés,Rosa M. A
author2_role author
author
dc.contributor.author.fl_str_mv Elias,Rosilene M.
Moe,Sharon
Moysés,Rosa M. A
dc.subject.por.fl_str_mv Chronic Kidney Disease-Mineral and Bone Disorder
Parathyroid
Calcium Transfer Mass
Vessels
Myocardium
topic Chronic Kidney Disease-Mineral and Bone Disorder
Parathyroid
Calcium Transfer Mass
Vessels
Myocardium
description Abstract Patients on hemodialysis are exposed to calcium via the dialysate at least three times a week. Changes in serum calcium vary according to calcium mass transfer during dialysis, which is dependent on the gradient between serum and dialysate calcium concentration (d[Ca]) and the skeleton turnover status that alters the ability of bone to incorporate calcium. Although underappreciated, the d[Ca] can potentially cause positive calcium balance that leads to systemic organ damage, including associations with mortality, myocardial dysfunction, hemodynamic tolerability, vascular calcification, and arrhythmias. The pathophysiology of these adverse effects includes serum calcium changes, parathyroid hormone suppression, and vascular calcification through indirect and direct effects. Some organs are more susceptible to alterations in calcium homeostasis. In this review, we discuss the existing data and potential mechanisms linking the d[Ca] to calcium balance with consequent dysfunction of the skeleton, myocardium, and arteries.
publishDate 2021
dc.date.none.fl_str_mv 2021-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000400539
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/2175-8239-jbn-2020-0098
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology v.43 n.4 2021
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
instacron:SBN
instname_str Sociedade Brasileira de Nefrologia (SBN)
instacron_str SBN
institution SBN
reponame_str Jornal Brasileiro de Nefrologia
collection Jornal Brasileiro de Nefrologia
repository.name.fl_str_mv Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)
repository.mail.fl_str_mv ||jbn@sbn.org.br
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