Increased Ionized Calcium and Myocardial Contractility during Hemodialysis

To the Editor: In their article in the January 5 issue, Henrich et al. present evidence that the increased ionized calcium concentration that results from hemodialysis is largely responsible for the increase in left ventricular contractility regularly observed after this procedure. 1 The hypothesis for their studies is based on in vivo and in vitro observations in cardiac muscle, which demonstrate the positive inotropic effects of calcium. 2 3 4 5 The conclusion of Henrich et al. may have a practical application in the use of furosemide (Lasix; Hoechst-Roussel, Somerville, N.J.) to treat patients with congestive heart failure. We have recently observed the acute and . . . No extract is available for articles shorter than 400 words.