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Reversible peritoneal calcification in a patient treated by CAPD.
Clinical Nephrology
|December 10, 1999
Summary
High glucose dialysate in long-term continuous ambulatory peritoneal dialysis (CAPD) may cause peritoneal calcification. Adjusting dialysate calcium and using phosphate binders mitigated calcification in a patient.
Area of Science:
- Nephrology
- Gastroenterology
- Radiology
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a common treatment for end-stage renal disease.
- Peritoneal calcification is a rare but serious complication of long-term CAPD.
- Etiologies include hyperparathyroidism, elevated calcium-phosphate product, and recurrent peritonitis.
Observation:
- A 65-year-old female on long-term CAPD developed diffuse peritoneal calcification.
- No symptoms of peritonitis or known risk factors were present.
- High glucose dialysate (3.86%) was used daily for 16 months prior to diagnosis.
Findings:
- The patient's peritoneal calcification was linked to the use of high glucose dialysate.
- No other common causes of peritoneal calcification were identified.
- Reducing dialysate calcium concentration and administering aluminum-containing phosphate binders led to mitigation of calcification.
Implications:
- High glucose dialysate may be an underrecognized cause of peritoneal calcification in CAPD patients.
- Careful monitoring of dialysate composition and calcium-phosphate metabolism is crucial.
- Intervention with dialysate modification and phosphate binders can reverse peritoneal calcification.