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Clinical application of low calcium peritoneal dialysate
H Kawanishi1, T Tsuchiya, S Namba
1Department of Artificial Organs, Akane-Foundation Tsuchiya Hospital, Hiroshima, Japan.
ASAIO Transactions
|July 1, 1991
Summary
Low calcium dialysate (LCa) in peritoneal dialysis showed a negative calcium balance, necessitating increased calcium and vitamin D supplements. This suggests LCa may become a new standard for stable patients.
Area of Science:
- Nephrology
- Biochemistry
Background:
- Peritoneal dialysis requires careful management of fluid and electrolyte balance.
- Calcium levels in dialysate impact patient calcium balance and bone health.
Purpose of the Study:
- To compare the equilibration and calcium mass transfer of low calcium dialysate (LCa) with conventional dialysates.
- To evaluate the clinical use of LCa in patients undergoing continuous ambulatory peritoneal dialysis.
Main Methods:
- Preparation of LCa (2.3 mEq/L) and comparison with conventional dialysates (3.5 and 4.0 mEq/L).
- Measurement of dialysate to plasma concentration ratios and daily calcium mass transfer.
- Clinical application of LCa in six patients over six months, monitoring medication adjustments.
Main Results:
- LCa exhibited a negative dialysate to plasma concentration ratio and a negative daily calcium mass transfer (-157 +/- 26 mg/day).
- Conventional dialysates showed positive or near-zero calcium balance.
- Patients on LCa required increased calcium carbonate and vitamin D supplementation.
Conclusions:
- Low calcium dialysate leads to a net calcium loss from the body.
- Increased oral calcium and vitamin D are necessary when using LCa.
- LCa may be a suitable option for stable continuous ambulatory peritoneal dialysis patients, with appropriate monitoring and supplementation.