Is control of secondary hyperparathyroidism optimal with the currently used calcium concentration in the CAPD fluid?

Progression of hyperparathyroidism and bone disease on CAPD has been noted by several authors. In our CAPD patients we observed that aluminium-containing phosphate binders were often required because administration of CaCO3 was limited by the development of hypercalcaemia particularly in patients concomitantly requiring calcitriol. We propose that CAPD fluids with lower calcium concentration should be evaluated to facilitate control of plasma phosphate and secondary hyperparathyroidism.