Clinical Usefulness of Low Calcium Dialysate in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients.
- Author:
Hyunjin NOH
;
Sug Kyun SHIN
;
Shin Wook KANG
;
Kyu Hun CHOI
;
Dae Suk HAN
;
Ho Yung LEE
- Publication Type:Original Article
- Keywords:
Hypercalcemia;
Phosphate binder;
Low calcium dialysate;
CAPD;
ESRD
- MeSH:
Alkaline Phosphatase;
Aluminum Hydroxide;
Calcium Carbonate;
Calcium*;
Humans;
Hypercalcemia;
Incidence;
Kidney Failure, Chronic;
Peritoneal Dialysis, Continuous Ambulatory*;
Peritonitis;
Renal Osteodystrophy;
Retrospective Studies
- From:Korean Journal of Nephrology
1998;17(5):779-785
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hypercalcemia is a common complication in CAPD patients treated with calcium-containing phosphate binders and using the standard dialysate (SCD) calcium concentration of 3.5mEq/L. We performed a retrospective study in 25 CAPD patients to determine whether a low calcium dialysate (LCD) containing 2.5mEq/L calcium would reduce the incidence of hypercalemia with adequate control of serum inorganic phosphate levels and diminish the need to use aluminum-containing phosphate binders. All patients had previously used SCD before converting to LCD. The incidence of hypercalcemia (more than 2 episodes of corrected serum calcium > or = 10.5mg/dL) tended to be lower after converting to LCDl 0.27 (0-2.76) vs. 0 (0-1.97) episodes/patient-yearl. Intact PTH level increased from 38.8 (0.1-1599.3)pg/mL to 70.6 (9.5-1540.0)pg/mL after conversion, but there was no statistical sifnificance. Serum calcium, inorganic phosphate, alkaline phosphatase and bicarbonate levels did not change after converting to LCD. We were able to reduce aluminum hydroxide dosagel 1.09 (0-10.88) vs. 0 (0-3.26)g/day/patientl and increase calcium carbonate dosage (1.95 0.92 vs. 2.98 2.14g/day/ patient) after conversion significantly (P<0.05). The frequency of peritonitis was similar in LCD and SCD period. In conclusion, low calcium dialysate is useful in diminishing aluminum-containing phosphate binder dosage and increasing calcium carbonate dosage to maintain a similar phosphate value. Its effects on renal osteodystrophy remain to be assessed.
