Calcium Free Type

  • Patients on chronic dialysis are susceptible to hypocalcaemia and an attempt is made to provide a positive calcium balance to prevent renal osteodystrophy.
  • In the setting of renal failure requiring dialysis, 61% of calcium is not bound to plasma proteins and is in a diffusible equilibrium during hemodialysis. As a result calcium may be lost in a calcium free dialysate up to 40 mg/L (1.0 mmol/L).
  • This is be prevented by adding calcium into the dilute dialysate at 1.75 mmol/L or 7.0 mg/dl or giving calcium intravenously at the same rate it is being lost. Reductions in ionized calcium have been linked to increased vascular instability during hemodialysis.

The composition of the dialysis solution is as follows:

PART I : The acid concentrate (in liquid form) is composed of the following components in each 1000ml:

  • NaCl : 165.00g
  • KCl: 6.00g
  • MgCl2: 3.70g
  • CH3COOH: 9.50g
  • H20: Q.S

PART II: The bicarb concentrate part containing

  • NaHCO3 : 660.0g
  • NaCl: 240.0g

Procedure for use:

  • Part I supplied in liquid form in white jerry cans of 10 lts.
  • Part II supplied in polythene bags of 900 g each (2 packs are supplied with each can)
  • The total contents of part II are dissolved in purified water up to 10lts
  • The operator manual of the individual dialysis machine should be followed to obtain the final dialysate options based on a compatible concentrate-pair and standard proportioning ratio to give a final solution by mixing 1:1.83:34 parts of part I:part II: purified water.

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