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Transperitoneal calcium balance in anuric continuous ambulatory peritoneal dialysis and automated peritoneal dialysis

Chieko Hamada1, Yasuhiko Tomino

  • 1Division of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo 113-8421, Japan.

International Journal of Nephrology
|August 13, 2013
PubMed

Insights

Automated peritoneal dialysis (APD) patients show reduced transperitoneal calcium removal compared to continuous ambulatory peritoneal dialysis (CAPD) due to shorter dwell times. This may impact bone metabolism in anuric patients undergoing APD.

Area of Science:

  • Nephrology
  • Mineral and Bone Disorders
  • Dialysis

Background:

  • Dialysis modalities significantly impact calcium and bone metabolism.
  • Hemodialysis (HD) patients experience fluctuating serum calcium and phosphate levels.
  • Automated peritoneal dialysis (APD) shares solute transport characteristics with HD.

Purpose of the Study:

  • To compare transperitoneal calcium removal between APD and CAPD in anuric patients.
  • To investigate the influence of dialysis modality on calcium balance.

Main Methods:

  • Analysis of biochemical parameters in 24-hour and 4-hour peritoneal effluents.
  • Study included twenty-three anuric patients undergoing APD.
  • Comparison of calcium removal in CAPD and APD.

Main Results:

  • Transperitoneal calcium removal was lower in APD compared to CAPD.
  • Calcium removal correlated with ultrafiltration during short dwell times.
  • Short dwell times in APD led to minimal or negative calcium removal and increased intact PTH levels.

Conclusions:

  • Shorter dialysate dwell times and frequent exchanges in APD may suppress transperitoneal calcium removal.
  • This suppression could affect calcium balance and bone metabolism in anuric APD patients.

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