Clinical application of low calcium peritoneal dialysate

Low calcium dialysate (LCa) with calcium levels of 2.3 mEq/L was prepared for peritoneal dialysis, and its equilibration was compared with those of conventional dialysates with calcium contents of 3.5 mEq/L and 4.0 mEq/L. The variation in dialysate to plasma concentration ratios of total calcium of conventional dialysates was positive; that of LCa was negative. Mass transfer of calcium per day was positive and normal for calciums of 4.0 mEq/L (31 +/- 51 mg/day) and 3.5 mEq/L (-37 +/- 40 mg/day), compared with a negative balance for LCa (-157 +/- 26 mg/day). The LCa was used in six patients over 6 months. The doses of calcium carbonate and vitamin D also were increased from 1.2 +/- 1.5 to 5.4 +/- 3.3 g/day (p less than 0.05) and from 0.17 +/- 0.2 to 0.38 +/- 0.47 micrograms/day, respectively. Aluminum gel was discontinued. Low calcium dialysate may become the standard dialysate for stable continuous ambulatory peritoneal dialysis patients.