Reversibility of parathyroid gland suppression in CAPD patients with low i-PTH levels.
The i-PTH response to changes in the peritoneal calcium balance was studied prospectively in a group of 13 stable CAPD patients, who presumably had adynamic bone disease, with low or normal i-PTH values and low aluminum in plasma. Five days after the reduction of dialysate calcium concentration from 1.75 mmol/l to 1 mmol/l, there was a significant elevation in the serum i-PTH. These increased PTH levels returned to baseline values when patients were changed to the 1.75 mmol/l Ca solution (p = 0.004). The changes in i-PTH mirrored the changes in peritoneal calcium balances. These results support the notion that the low or normal levels of i-PTH frequently seen in peritoneal dialysis patients are due to the hypercalcemic effects of the standard peritoneal dialysis solutions; in these patients, the parathyroid hormone production is normal since negative peritoneal balances of calcium are associated with an increase in serum i-PTH.
Montenegro
J
J
Nefrología, Hospital de Galdácano, Vizcaya, Spain.
Saracho
R
R
González
O
O
Moina
I
I
Martínez
I
I
D000328:Adult; D000368:Aged; D000535:Aluminum / Q000097:blood; D002118:Calcium / Q000008:administration & dosage*; D015314:Dialysis Solutions / Q000032:analysis*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000503:physiopathology*; D010281:Parathyroid Hormone / Q000097:blood*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011446:Prospective Studies
D015314:Dialysis Solutions; D010281:Parathyroid Hormone; D000535:Aluminum; D002118:Calcium