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Abstract: TH-PO223

High Serum Calcium and Parathyroid Hormone Are Risk Factors of Intradialytic Hypotension in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Su, Ning, The Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
  • Liang, Mengjun, The Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
  • Jiang, Zongpei, The Six Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Background

Hypercalcemia and high serum intact parathyroid hormone(iPTH) are involved in the pathogenesis of vascular calcification. But the relationship between hypercalcemia and iPTH with intradialytic hypotension (IDH) is unclear.

Methods

This is a retrospectively cohort study, 922 HD patients were enrolled from 10 HD facilities in China. The patients were categorized into hypercalcemia group and hypocalcemia group according whether the serum corrected calcium levels ≥ 8.67mg/dl (the median of serum corrected calcium in all patients), which were further categorized into high PTH(serum intact PTH>300pg/ml) and low PTH(serum intact PTH≤300pg/ml) groups. Not only the clinic characters, especially the pre and post dialysis blood pressure were analyzed between the four groups, but also the risk factors of IDH were studied by multiple logistic regression in all HD patients.

Results

The prevalence of IDH was much higher in patients of hypercalcemia and high PTH than those of hypocalcemia and low PTH (21.1% vs. 9.6%, p<0.001). Adjusted with age, dialysis vintage, gender, diabetes mellitus, BMI, Kt/V, serum albumin, and hemoglobulin, logistic multiple regression analysis determined that hypercalcemia (OR:2.477, 95%CI: 1.632-3.758, P<0.001) (Model1), and hypercalcemia accompany with high PTH (OR:2.634, 95%CI: 1.378-5.031, P=0.003) (Model2) were risk factors of IDH. Furthermore, increasing ultrafiltration was also risk factor of IDH (Model1OR:1.409, 95%CI: 1.072-1.851, P=0.014; Model2 OR:1.397, 95%CI: 1.061-1.839, P=0.017). However, hemodiafiltration (HDF) was a protective factor of IDH in the patients (Model1 OR:0.441, 95%CI: 0.281-0.693, P<0.001; Model2 OR:0.442, 95%CI: 0.281-0.694, P<0.001).

Conclusion

Not only increasing ultrafiltration, but also high serum calcium and PTH are the risk factors of IDH. Furthermore, the hemodiafiltration will lower the risk of IDH compared with hemodialysis.

Fig.1 Associations between serum calcium, PTH levels, and the prevalence of IDH.

Funding

  • Other U.S. Government Support