الفهرس 
INTRODUCTION AND AIM OF THE WORKOnly 14 pages are availabe for public view
 |  | from | 169 |  |  |
| | | from | 169 | | |
Abstract
The role of calcium in dialysis patients lies mainly into 2 main issues:
- Cardiovascular stability.
- Renal bone disease and vascular calcification
The choice of dialysate calcium concentration is able to influence many of the most important factors in the successful management of chronic HD patients
A potential harmful effect of reducing calcium concentrations in the dialysate for hemodialysis patients is that excessive lowering may lead to an increased risk of cardiac rhythm disturbances and sudden cardiac arrest (SCA). SCA is known to be the leading cause of death among hemodialysis patients, accounting for one in every four deaths.
The goal of this study is to assess the possible effect of dialysate calcium concentration on cardiac arrhythmia in prevalent hemodialysis patients.
The study was conducted on 21 chronic renal failure patients on regular haemodialysis for more than 6 months. They were dialyzed with 1.25 mmol/l calcium concentration in dialysate. Then they were switched to 1.5 mmol/l calcium dialysate. All patients were thoroughly interrogated and examined clinically and were subjected to Kidney function tests, Complete blood count, Total Serum calcium, Serum phosphorus and Serum albumin. Ionized Calcium and Potassium were done before and after sessions. ECG monitoring was done for patients through sessions and QTc was measured before and every hour in sessions. Then data were collected and statistically analysed.
This study demonstrated that there is no significant change in serum ionized calcium in both sessions using 1.25mmol/l and 1.5mmol/l calcium dialysates.
Regarding ECG we found that heart rhythm disorders observed more with calcium dialysate 1.25mmol/l.
With respect to QTc, there was no QTc prolongation in neither 1.25 nor 1.5 mmol/l calcium dialysate sessions, This may be because of small number of study group.
But at the end of each session QTc in 1.25mmol/l in comparison to 1.5mmol/l session is more prolonged. There is only significance after 2 hours of sessions between 1.25 and 1.5 mmol/l calcium dialysate sessions with p value 0.015.
Regarding potassium, QTc has a positive significance with serum potassium. Also a positive significance was observed between level of serum potassium before and after in both sessions. Also potassium is the only factor that is affecting QTc that appear by regression test.
These means that potassium has a great role in prolonging QTc. The question now is: Is serum potassium change with changing calcium concentration in dialysate? This Question need to be more researched and studied.