CALCIUM-FREE HEMODIALYSIS - EXPERIENCE IN THE TREATMENT OF 33 PATIENTS WITH SEVERE HYPERCALCEMIA

Objective: To assess the efficacy, adverse effects and relevance of ca lcium-free hemodialysis (CFHD) in the treatment of major hypercalcemia . Design: Retrospective chart review. Setting: Medical ICU. Patients: All patients admitted over a 9-year period for hypercalcemia requiring urgent treatment and who underwent hemodialysis. Interventions: CFHD with an acetate dialysate. Main results: Thirty-three patients with se vere hypercalcemia from various etiologies received CFHD. Marked and r apid decrease of serum total calcium was obtained during all sessions (mean decrease: 1.71 +/- 0.54 mmol/l). Calcium rebound within 24 h aft er CFHD was observed in all evaluable cases (1 +/- 0.45 mmol/l; mean d elay 13.7 +/- 5.8 h). Adverse cardiovascular effects occurred in 17 of 48 sessions (35%) and in 13 of 30 evaluable patients (43%). Conclusio ns: Adverse effects are frequent during CFHD. After correction of hypo volemia, its use should be restricted to patients with severe clinical symptoms or advanced renal impairment.