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Vaginal infections are a very common cause for the pH of the vagina to rise. The most common vaginal infection in my practice (and in all doctor's offices) is Bacterial Vaginosis which causes the normal vaginal pH to rise to above 4.5. Odor usually occurs with Bacterial Vaginosis.
The use of low-calcium dialysate has been associated with decreased LV contractility and a corresponding decrease in blood pressure. It was further associated with a significant intradialytic decrease in blood pressure in both healthy and cardiac-compromised HD patients and patients with decreased LV ejection fraction.