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Title: Evaluation of magnesium homeostatis in patients with chronic dialysis treatment

Abstract:

The aim of this study was to evaluate disturbances of magnesium homeostasis in renal replacement therapy patients treated with hemodialysis or continuous ambulatory peritoneal dialysis. In particular the subject of investigation of given below problems: · Comparison of total magnesium concentrations and ionized magnesium concentrations before and after hemodialysis. · Evaluation of total magnesium concentrations and ionized magnesium concentrations in patients treated with continuous ambulatory peritoneal dialysis. · Comparison of renal replacement therapy influence on total magnesium concentrations and ionized magnesium concentrations in 2 group of patients: treated with hemodialysis and with continuous ambulatory peritoneal dialysis. · Researching of connections between total magnesium concentrations and ionized magnesium concentrations, and other laboratory parameters, as well as parameters used for evaluation of dialysis efficiency. · Comparison of ionized magnesium concentrations measured in actual pH and ionized magnesium concentrations adjusted to physiological pH 7,4, measured in the same samples. Ionized magnesium concentrations was measured with magnesium ion-selective electrode (analyzer Microlyte 6, KONE). Other laboratory parameters were measured with methods routinely used in medical laboratories. Laboratory investigations used in this dissertation were performed in Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University in Krakow. All investigations were performed in period of 7-month observation in two groups of patients on renal replacement therapy: · Patients on hemodialysis (172 persons). · Patient on continuous ambulatory peritoneal dialysis (61 persons). The carried studies lead to the following conclusions: · Serum total magnesium concentrations and serum ionized magnesium concentrations (adjusted to pH 7,4) has showed slight hipermagnesemia in both groups of patients: on hemodialysis and on continuous ambulatory peritoneal dialysis. · Changes of serum total magnesium concentration and serum ionized magnesium concentration (adjusted to pH 7,4) occurred during procedure of hemodialysis are clinically non relevant. · Even though serum total magnesium concentration in continuous ambulatory peritoneal dialysis patients is not much higher than values found in healthy population (1,24 ± 0,23 mmol/L), serum ionized magnesium concentration adjusted to pH 7,4 (1,18 ± 0,33 mmol/L) is much more higher than upper limit of reference values. Similarly calculated value of ionized magnesium concentration fraction (94,46 ± 5,11%) is much more higher than values found in healthy population. Practically almost 100% of magnesium in blood of patients on continuous ambulatory peritoneal dialysis treatment exists in the ionized form. This is the most significant difference in comparison to patients on hemodialysis, where both serum total magnesium concentration and serum ionized magnesium concentration values are not much higher than values found in healthy population. · Serum total magnesium concentration, serum ionized magnesium concentrations (adjusted to pH 7,4) and serum ionized magnesium fraction (adjusted to pH 7,4) in both group of patients on renal replacement therapy are stable in 7-months period of observation, when the same scheme of dialysotherapy and pharmacotherapy is used. Values of serum total magnesium concentration, serum ionized magnesium concentrations (adjusted to pH 7,4) and serum ionized magnesium fraction (adjusted to pH 7,4) do not depend on gender, duration of renal replacement therapy, reason of renal insufficiency and values of parameters used for evaluation of dialysis efficiency. · In both group of patients values of ionized magnesium concentration measured in actual serum pH are significantly lower than values of ionized magnesium concentration adjusted to physiological pH 7,4. ; That`s why if ionized magnesium concentration is measured in serum obtained in non anaerobic way it is necessary to use ionized magnesium concentration adjusted to physiological pH 7,4, because this value is identical with value of ionized magnesium concentration found in vivo.

Level of degree:

2 - studia doktoranckie

Degree discipline:

biochemia ; nefrologia

Degree grantor:

Wydział Lekarski

Promoter:

Jerzy W. Naskalski

Date issued:

2007

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:952

Call number:

ZB-106438

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tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

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Last modified:

Feb 12, 2020

In our library since:

Nov 21, 2012

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http://dl.cm-uj.krakow.pl:8080/publication/952

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ZB-106438 Feb 12, 2020
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