Abstract
Abstract
Introduction
Although vascular calcification is a recognised complication for haemodialysis patients, peritoneal dialysis (PD) patients are also at risk. As such we wished to review peritoneal and urinary calcium balance and the effect of calcium containing phosphate binders (CCPBs).
Methods
Twenty-four-hour peritoneal calcium balance and urinary calcium were reviewed in PD patients undergoing their first assessment of peritoneal membrane function.
Results
Results from 183 patients, 56.3% male, 30.1% diabetic, mean age 59.4 ± 16.4 years, median 2.0 (2–6) months of PD, 29% treated by automated PD (APD), 26.8% continuous ambulatory (CAPD) and 44.2% APD with a day-time exchange (CCPD) were reviewed. Peritoneal calcium balance was positive in 42.6%, and remained positive in 21.3% after including urinary calcium losses. PD calcium balance was negatively associated with ultrafiltration (odds ratio 0.99 (95% confidence limits 0.98–0.99), p = 0.005. PD calcium balance was lowest with APD (APD − 0.45 (− 0.78 to 0.05) vs CAPD − 0.14 (− 1.18 to 0.59) vs CCPD − 0.03) − 0.48 to 0.5) mmol/day), p < 0.05, with 82.1% of patients with a positive balance prescribed icodextrin, when combining peritoneal and urinary losses. When considering CCPB prescription, then 97.8% of subjects prescribed CCPD had an over-all positive calcium balance.
Discussion
Over 40% of PD patients had a positive peritoneal calcium balance. Elemental calcium intake from CCPB had a major effect on calcium balance, as median combined peritoneal and urinary calcium losses were < 0.7 mmol/day (26 mg), so caution is required to prevent excessive CCPB prescribing, increasing the exchangeable calcium pool and thus potentially increasing vascular calcification, particularly for anuric patients.
Graphical abstract
Publisher
Springer Science and Business Media LLC
Reference35 articles.
1. Wang AY (2014) Calcium balance and negative impact of calcium load in peritoneal dialysis patients. Perit Dial Int 34(4):345–352
2. Armstrong A, Beer J, Noonan K, Cunningham J (1997) Reduced calcium dialysate in CAPD patients: efficacy and limitations. Nephrol Dial Transplant 12(6):1223–1228
3. Zhao HP, Wu B, Lu LX, Qiao J, Wu XL, Wang M (2012) Effect of combining different calcium concentration dialysate on calcium balance in peritoneal dialysis patients. Chin Med J (Engl) 125(22):4009–4013
4. Montenegro J, Saracho R, Aguirre R, Martinez I (1993) Calcium mass transfer in CAPD: the role of convective transport. Nephrol Dial Transplant 8(11):1234–1236
5. Hamada C, Tomino Y (2013) Transperitoneal calcium balance in anuric continuous ambulatory peritoneal dialysis and automated peritoneal dialysis patients. Int J Nephrol 2013:863791
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献