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Ansu Baidoo VY, Cara KC, Dickinson SL, Brown AW, Wallace TC, Chung M, Gletsu-Miller N. Systematic Review and Meta-Analysis to Estimate a Reference Range for Circulating Ionized Magnesium Concentrations in Adult Populations. J Nutr 2023; 153:3458-3471. [PMID: 37844840 DOI: 10.1016/j.tjnut.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/14/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND There is a lack of consensus on a reference range for ionized magnesium (iMg2+) in blood as a measure of the status of circulating iMg2+ for the screening of populations. OBJECTIVES We estimated the reference range of iMg2+ levels for healthy adult populations and the ranges for populations with cardiovascular disease (CVD), type 2 diabetes, hypertension, and renal disease. We also estimated 95% ranges for circulating magnesium (Mg) in healthy and those with cardiometabolic diseases. METHODS We searched Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Embase through 24 July, 2020 to identify articles. We included English, peer-reviewed, randomized controlled trials, prospective and retrospective cohort studies, case-control studies, and cross-sectional studies that measured iMg2+ in blood or circulating Mg at baseline. The protocol was registered on PROSPERO (CRD42020216100). Estimated ranges were calculated by employing a frequentist random-effects model using extracted (or calculated) means and SDs from each included study. We determined the 95% confidence interval of the pooled mean. RESULTS A total of 95 articles were included with 53 studies having data for healthy participants and 42 studies having data for participants with cardiometabolic diseases. The estimated reference range for iMg2+ for healthy populations was 0.40-0.68 mmol/L, 0.38-0.64 mmol/L for CVD, 0.34-0.66 mmol/L for type 2 diabetes, 0.39-1.04 mmol/L for hypertension, and 0.40-0.76 mmol/L for renal disease. For circulating Mg, the estimated range was 0.72-1.0 mmol/L for healthy adults, 0.56-1.05 mmol/L for CVD, 0.58-1.14 mmol/L for type 2 diabetes, 0.60-1.08 mmol/L for hypertension, and 0.59-1.26 mmol/L for renal disease. CONCLUSIONS Estimated reference ranges for cardiometabolic disease states for both iMg2+ and circulating Mg were broad and overlapped with the estimated range for healthy populations (0.40-0.68 mmol/L). Further studies should evaluate whether iMg2+ can be used as a biomarker of cardiometabolic disease.
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Affiliation(s)
| | - Kelly C Cara
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Stephanie L Dickinson
- School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Andrew W Brown
- University of Arkansas for Medical Sciences, Little Rock, AR, United States; Arkansas Children's Research Institute, Little Rock, AR, United States
| | - Taylor C Wallace
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, United States; Think Healthy Group, Inc., Washington, DC, United States; Center for Magnesium Education & Research, Pahoa, HI, United States
| | - Mei Chung
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Nana Gletsu-Miller
- School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States.
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Barrientos-Galeana E, Tolentino-Dolores MC, Morales-Hernández RM, Sámano R, Chico-Barba G, Fernández-Sánchez E, Zamora-Sánchez LJ, Alonso-López AD, López-Martínez H, Alba-Rosales T, Sánchez-Guerrero SA. Bone Turnover Markers Changes Induced by Plateletpheresis May Be Minimized with Oral Supplementation of Calcium, Minerals, and Vitamin D before the Procedures: A Non-Randomized, Controlled Study. J Clin Med 2022; 12:jcm12010281. [PMID: 36615081 PMCID: PMC9821577 DOI: 10.3390/jcm12010281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/31/2022] Open
Abstract
Apheresis allows the collection of specific blood components but changes serum calcium (Ca), magnesium (Mg), copper (Cu), zinc (Zn), and hormones involved in bone metabolism due to citrate infusion. We assessed the effect of oral supplementation of calcium, vitamin D, and minerals as pills or an enriched diet before plateletpheresis donation on levels of divalent cations, hormones, and bone turnover markers that may prevent metabolic changes. Methods: Non-randomized controlled study including 134 donors. Serum parathyroid hormone (PTH), Ca, Mg, Zn, Cu, osteocalcin (OC), vitamin D, and type-1 collagen C-terminal telopeptide (CTX-1) levels were measured at baseline and post-procedure. Donors were divided into four groups: supplemented with calcium carbonate and vitamin D (cal + vitd); those receiving calcium, minerals, and vitamin D (cal + vitd + min); those receiving a calcium-rich diet (diet) and a control group (control). Results: PTH levels increased >1-fold, whereas tCa, tMg, Zn, Cu, iCa, iMg, and vitamin D levels decreased immediately after apheresis amongst donors of any group; when these levels were measured two weeks later, donors in the calcium-vitd and cal + vitd + min groups returned to basal values; donors in the cal + vitd + min group were the only group that kept their levels of OC and CTX unchanged at the different study times. Conclusions: Bone turnover markers changes induced by plateletpheresis may be minimized with oral supplementation of calcium, minerals, and vitamin D two days before the procedures.
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Affiliation(s)
- Edgar Barrientos-Galeana
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
- Blood Bank Department, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
- Correspondence: (E.B.-G.); (S.A.S.-G.)
| | | | | | - Reyna Sámano
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | - Gabriela Chico-Barba
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | | | | | | | | | - Tania Alba-Rosales
- Blood Bank Department, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Sergio Arturo Sánchez-Guerrero
- Blood Bank Department, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
- Correspondence: (E.B.-G.); (S.A.S.-G.)
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Kukar N, Syal N, Arora H, Kaur A, Handa A, Maharishi RN. Assessment of pre and post donation changes in hematological parameters and serum calcium and magnesium levels in plateletpheresis donors. J Family Med Prim Care 2022; 11:1489-1492. [PMID: 35516708 PMCID: PMC9067219 DOI: 10.4103/jfmpc.jfmpc_1409_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 11/04/2022] Open
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Yamada C, Pipe SW, Zhao L, Leichtman AB, Samaniego M, Sung RS, Davenport RD. Coagulation status after therapeutic plasma exchange using citrate in kidney transplant recipients. Transfusion 2016; 56:3073-3080. [DOI: 10.1111/trf.13803] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/26/2016] [Accepted: 07/26/2016] [Indexed: 12/15/2022]
Affiliation(s)
- Chisa Yamada
- Department of Pathology; University of Michigan; Ann Arbor Michigan
| | - Steven W. Pipe
- Department of Pediatrics/Pathology; University of Michigan; Ann Arbor Michigan
| | - Lili Zhao
- Department of Biostatistics; University of Michigan; Ann Arbor Michigan
| | - Alan B. Leichtman
- Department of Internal Medicine; University of Michigan; Ann Arbor Michigan
| | - Milagros Samaniego
- Department of Internal Medicine; University of Michigan; Ann Arbor Michigan
| | - Randall S. Sung
- Department of Surgery; University of Michigan; Ann Arbor Michigan
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Both acute delivery of and storage with magnesium sulfate promote cold-stored platelet aggregation and coagulation function. J Trauma Acute Care Surg 2015; 79:S139-45. [DOI: 10.1097/ta.0000000000000739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sengul Samanci N, Ayer M, Gursu M, Ar MC, Yel K, Ergen A, Dogan EE, Karadag S, Cebeci E, Toptas M, Kazancioglu R, Ozturk S. Patients treated with therapeutic plasma exchange: a single center experience. Transfus Apher Sci 2014; 51:83-9. [PMID: 25457747 DOI: 10.1016/j.transci.2014.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 10/06/2014] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Therapeutic Plasma Exchange (TPE) is a therapeutic procedure that is used to remove high molecular weight substances from plasma. We analyzed data of patients who received TPE during the last 7 years, and focused on the efficiency of TPE in various disease groups. MATERIAL AND METHODS We studied 110 patients treated with TPE by membrane plasma separation technique from 2007 to 2013. We examined the demographic data, underlying disease, biochemical parameters, volume and type of replacement fluid, complications, concomitant treatment, the need for hemodialysis and number of TPE sessions. RESULTS One hundred ten patients, 58 male, 52 female were included. The mean age was 47.3 ± 17.6 years. A total of 734 TPE sessions were performed and the mean number of TPE sessions per patient was 6.6 ± 4.3. The underlying disease was renal transplantation in 26 patients, ANCA-associated vasculitis in 18, rapidly progressive glomerulonephritis in 17, hemolytic uremic syndrome in 11, thrombotic thrombocytopenic purpura in 9, autoimmunic hemolytic anemia in 6, focal segmental glomerulosclerosis in 6 and other diseases. Partial and complete remission was obtained in 65 (59.1%) and 24 patients (21.8%) respectively, while 14 (12.7%) patients had no response and 7 (6.4%) patients died. Complications were muscle cramps (6.4%), allergic reactions (4.5%), severe hypotension (3.6%), fever (1.8%), unconsciousness (0.9%), leukopenia (0.9%) and catheter related hematoma (0.9%). CONCLUSION According to our 7 years of experience in TPE, we can say that therapeutic plasma exchange by membrane separation technique is a useful, easy, available and effective life-saving therapeutic treatment.
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Affiliation(s)
- Nilay Sengul Samanci
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey.
| | - Mesut Ayer
- Department of Hematology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Meltem Gursu
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Muhlis Cem Ar
- Department of Hematology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Kubra Yel
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Abdulkadir Ergen
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Elif Ece Dogan
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Serhat Karadag
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Egemen Cebeci
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Toptas
- Department of Intensive Care Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Rumeyza Kazancioglu
- Department of Nephrology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Savas Ozturk
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
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Efficacy and safety of plasma exchange: ann 11-year single-center experience of 2730 procedures in 317 patients. Transfus Apher Sci 2014; 51:209-14. [PMID: 25217991 DOI: 10.1016/j.transci.2014.08.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 07/14/2014] [Accepted: 08/25/2014] [Indexed: 01/30/2023]
Abstract
We reviewed retrospectively 317 patients who received 2730 plasma exchange (PE) procedures. According to guidelines published by the American Society for Apheresis (ASFA) in 2013, there were 220 (69%), 55 (17%), 32 (9%), and 7 (4%) patients who were treated with PE for a disease or condition considered as category I, II, III, and IV, respectively. Overall, 73%, 72%, and 69% of the patients showed an improvement of the underlying disease or condition at the end of the PE, and at 3 months and at 6 months after finishing the PE, respectively. We observed adverse effects in 90 (3%) PEs.
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Current topics in therapeutic plasmapheresis. Clin Exp Nephrol 2013; 18:41-9. [PMID: 23887747 DOI: 10.1007/s10157-013-0838-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 06/27/2013] [Indexed: 12/14/2022]
Abstract
Therapeutic plasmapheresis has been used for intractable diseases that cannot be cured by conventional drug therapy. Currently, the use of therapeutic plasmapheresis has been approved for 27 diseases by Japan's National Health Insurance system and is mainly categorized into three modalities: plasma exchange (PE), double-filtration plasmapheresis (DFPP), and plasma adsorption (PA). Plasma separators and/or fractionators are essential for the therapy. PE is performed for two purposes: removal of pathogenic antigens or substances in the plasma fraction and supplementation of essential factors, such as albumin and coagulation factors. PE can be used for thrombotic microangiopathy and acute hepatic failure. DFPP can be performed for selective removal of macromolecules while avoiding the use of substitution fluid (i.e., albumin or fresh frozen plasma). DFPP has now been used for conditions involving relatively larger plasma molecules, including hyperviscosity syndrome and ABO-incompatible kidney transplantation. PA can specifically remove pathogenic agents, such as low-density lipoprotein or autoantibodies, in the IgG fractions by the adsorption column and does not require substitution fluids. PA has now been used for a wide variety of neurological diseases, including chronic inflammatory demyelinating polyneuropathy. This review describes the characteristics of each modality, seeking to improve the efficacy and specificity of removal of the target substance.
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Donmez A, Arik B, Tombuloglu M, Cagirgan S. Risk factors for adverse events during collection of peripheral blood stem cells. Transfus Apher Sci 2011; 45:13-6. [DOI: 10.1016/j.transci.2011.06.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Balogun RA, Ogunniyi A, Sanford K, Okafor C, Lobo PI, Siami G, Barcia J, Kaplan AA. Therapeutic apheresis in special populations. J Clin Apher 2010; 25:265-74. [DOI: 10.1002/jca.20250] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Callan MB, Appleman EH, Shofer FS, Mason NJ, Brainard BM, Groman RP. Clinical and clinicopathologic effects of plateletpheresis on healthy donor dogs. Transfusion 2008; 48:2214-21. [DOI: 10.1111/j.1537-2995.2008.01803.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Boga C, Kozanoglu I, Yeral M, Bakar C. Assessment of corrected QT interval in sickle-cell disease patients who undergo erythroapheresis. Transfus Med 2008; 17:466-72. [PMID: 18067651 DOI: 10.1111/j.1365-3148.2007.00801.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Extension of the QT interval is characterized by syncope and cardiac arrest and often occurs in association with medical therapies and procedures. Whether erythroapheresis (EPH) could influence the QT interval duration in patients with sickle cell disease (SCD) is not known. We aimed to investigate the effects of EPH on the heart rate-corrected QT (QTc) interval. The study included 25 patients with SCD who underwent 34 EPH procedures. Two independent observers measured QTc interval duration from electrocardiograms performed continuously for 3 min at three different points during the EPH procedures (prior to EPH, after completion of 50% EPH and 15 min after EPH). Multiple regression analysis was used to determine if the ionized plasma calcium, the level of plasma magnesium, citrate infusion rate and painful crisis significantly contributed to the QTc interval. There was a non-significant trend (P = 0.184) towards increased QTc in sickle cell patients during EPH compared with pre-EPH values. QTc prolongation (>440 ms) occurred in 72% of the procedures. Fifty percent QTc values returned to baseline after the procedure. The independent variables were not significantly associated with QTc interval. Exchange procedures can induce QTc prolongation in patients with SCD.
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Affiliation(s)
- C Boga
- Department of Hematology, Baskent University Faculty of Medicine, Ankara, Turkey.
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Conway JCD, Liparini A, de Oliveira JR, Belchior JC. Analyses of the temperature and pH effects on the complexation of magnesium and calcium in human blood plasma: an approach using artificial neural networks. Anal Bioanal Chem 2007; 389:1585-94. [PMID: 17874236 DOI: 10.1007/s00216-007-1544-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Revised: 07/28/2007] [Accepted: 08/02/2007] [Indexed: 11/27/2022]
Abstract
The temperature and pH effects on the equilibrium of a blood plasma model have been studied on the basis of artificial neural networks. The proposed blood plasma was modeled considering two important metals, calcium and magnesium, and six ligands, namely, alanate, carbonate, citrate, glycinate, histidinate and succinate. A large data set has been used to simulate different concentrations of magnesium and calcium as a function of temperature and pH and these data were used for training the neural network. The proposed model allowed different types of analyses, such as the effects of pH on calcium and magnesium concentrations, the competition between calcium and magnesium for ligands and the effects of temperature on calcium and magnesium concentrations. The model developed was also used to predict how the variation of calcium concentration can affect magnesium concentrations. A comparison of neural network predictions against experimental data produced errors of about 3%. Moreover, in agreement with experimental measurements (Wang et al. in Arch. Pathol. 126:947-950, 2002; Heining et al. in Scand. J. Clin. Lab. Invest. 43:709-714, 1983), the artificial neural network predicted that calcium and magnesium concentrations decrease when pH increases. Similarly, the magnesium concentrations are less sensitive than calcium concentrations to pH changes. It is also found that both calcium and magnesium concentrations decrease when the temperature increases. Finally, the theoretical model also predicted that an increase of calcium concentrations will lead to an increase of magnesium concentration almost at the same rate. These results suggest that artificial neural networks can be efficiently applied as a complementary tool for studying metal ion complexation, with especial attention to the blood plasma analysis.
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Affiliation(s)
- J C D Conway
- Departamento de Química - ICEx, Universidade Federal de Minas Gerais, Av. Antônio Carlos 6627, Pampulha, 31270-901 Belo Horizonte, Minas Gerais, Brazil
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Palfi M, Martinsson L, Sundström K. Hypocalcemic symptoms during plateletpheresis using the COBE Spectra: a comparison of oral combination of 600mg calcium+300mg magnesium+100IU vitamin D3 vs. a 1000mg calcium in symptomatic donors. Transfus Apher Sci 2007; 36:291-5. [PMID: 17613274 DOI: 10.1016/j.transci.2007.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2007] [Accepted: 03/20/2007] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study was to find an effective treatment for hypocalcemic symptoms during plateletpheresis and to evaluate if a combination of calcium, magnesium and vitamin D3 is more effective in comparison to routine calcium supplementation. MATERIAL AND METHODS A study group consisting of 10 donors, having a history of previous hypocalcemic symptoms during plateletpheresis, donated platelets twice in a one-month period. During the first donation combination tablets (600mg Ca+300mg Mg+100IU vitamin D3) were used to treat hypocalcemic symptoms while routine treatment calcium carbonate tablets (1000mg Ca) were used during the second donation. If symptoms persisted after 10min the same dose was repeated. A control group, with no supplementation, consisting of five donors, with no history of hypocalcemic symptoms, were included. Donor subjective symptoms were graded and recorded on four occasions: at the start of plateletpheresis, when symptoms appeared, 10min after the first tablet and at the end of donation. Samples for analysis of ionized calcium (iCa), magnesium and potassium were also taken at the same occasions. RESULTS All donors from the study group experienced minor or medium hypocalcemic symptoms and needed a second dose of supplementation. Calcium carbonate tablets completely relieved the hypocalcemic symptoms in six donors, it had no effect on three donors and one donor experienced aggravated symptoms. The combination tablets completely relieved the symptoms in three donors, one donor experienced a partial relief and six donors had no relief of symptoms. There were no significant differences in iCa, potassium and magnesium levels were noted in the study group irrespective of which tablets were used for treatment of hypocalcemic symptoms. After plateletpheresis the median iCa levels declined by 30% and potassium levels declined by 3-11% in all donors while the magnesium levels were not significantly affected. There was no correlation between the presence of symptoms and the changed levels of iCa or magnesium. CONCLUSION Addition of magnesium and vitamin D3 to calcium seems to have no beneficial effect in the treatment of hypocalcemic symptoms in plateletpheresis donors.
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Affiliation(s)
- Miodrag Palfi
- Department of Transfusion Medicine and Clinical Immunology, University Hospital, 581 85 Linköping, Sweden.
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