title: The requirement of low calcium dialysate in patients on continuous ambulatory peritoneal dialysis receiving calcium carbonate as a phosphate binder.
abstract: In the present study we investigated the requirement of low calcium dialysate in 35 patients on continuous ambulatory peritoneal dialysis (CAPD) receiving calcium carbonate as the sole phosphate binder over a 12-month period. Patients with corrected serum calcium > or = 2.85 mmol/L after switching to oral calcium carbonate were given 1 to 3 2-litre exchanges of 2.5 mEq/L calcium dialysate. Serum phosphate level dropped from the pretreatment value of 2.95 +/- 0.62 to a level of between 1.70 +/- 0.41 to 2.03 +/- 0.44 mmol/L 2 weeks after therapy. Corrected serum calcium level increased significantly from 2 weeks onwards. Serum alkaline phosphatase rose initially at 2 and 6 weeks and decreased from 3 months onwards. Serum parathyroid hormone level dropped significantly from a mean pretreatment level of 569 to 320 pg/ml after 12 months (p < 0.001). Serum aluminum decreased significantly from a mean of 1.04 to 0.65 umol/L (p < 0.01). Daily calcium carbonate requirement fluctuated but tended to increase till 8 months and plateaued and ranged from 2.61 +/- 0.57 to 3.98 +/- 2.11 gm. The daily requirement of low calcium dialysate followed a similar trend with approximately three-quarters of patients ultimately requiring at least 1 bag of low calcium dialysate. Eight patients did not require low calcium dialysate. Patients who required low calcium dialysate were significantly older, had a significantly lower pretreatment serum parathyroid hormone and higher serum aluminum levels than those who did not.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medicine, University of Hong Kong.
authors.forename: I K
authors.initials: IK
authors.lastname: Cheng
authors.forename: H B
authors.initials: HB
authors.lastname: Lu
authors.forename: C Y
authors.initials: CY
authors.lastname: Chan
authors.forename: S W
authors.initials: SW
authors.lastname: Cheng
authors.forename: J D
authors.initials: JD
authors.lastname: Robinson
authors.forename: S C
authors.initials: SC
authors.lastname: Tam
authors.forename: W K
authors.initials: WK
authors.lastname: Lo
authors.forename: W C
authors.initials: WC
authors.lastname: Cheung
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000535:Aluminum / Q000097:blood; D002118:Calcium / Q000032:analysis*; D002119:Calcium Carbonate / Q000008:administration & dosage*; D015314:Dialysis Solutions / Q000737:chemistry*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010710:Phosphates / Q000097:blood
chemical_list: D015314:Dialysis Solutions; D010281:Parathyroid Hormone; D010710:Phosphates; D000535:Aluminum; D000469:Alkaline Phosphatase; D002119:Calcium Carbonate; D002118:Calcium