Skeletal and cardiovascular consequences of a positive calcium balance during hemodialysis
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
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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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 |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000400539 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021000400539 |
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 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
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 |
_version_ |
1752122066882002944 |