Low- and high-turnover bone disease in continuous ambulatory peritoneal dialysis: effects of low-Ca2+ peritoneal dialysis solution.

摘要: Calcium carbonate (CaCO3) is an effective phosphate (PO4) binder in uremics, and its use reduces aluminum (Al) intake. By maintaining high serum Ca2+, it decreases parathyroid hormone (PTH) levels. Hypercalcemia, however, often limits the dosage. In order to evaluate effects of a low-Ca peritoneal dialysis solution (PDS) (1.25 mmol/L) on Ca metabolism, we studied following 12 continuous ambulatory (CAPD) patients with hypercalcemia (6 low PTH levels, low-turnover bone disease, group 1, 6 high-turnover 2, documented by biopsies): Ca2+; PTH; morphology. The follow-up was months. Results show that both groups within third month there decrease Ca2+. 1 increased, reaching norm, 2 further increased exceeding norm. Because Ca2+ normal, possible increase oral CaCO3 (10.5 +/- 2.5 g/day) control PO4 levels stop Al gels. avoid rise PTH, PDS supplemented micrograms/day 1,25(OH)2D3 (vitamin D3); this followed reduction no PO4. may be useful preventing CAPD treated doses improving while vitamin D3 improves disease.