Dynamic observing the effect of different calcium concentration peritoneal dialysate on calcium-phosphorus metabolism in uremia patients under peritoneal dialysis

Abstract

Objective To observe the effect of different calcium concentration peritoneal dialysate on calcium-phosphorus metabohsm in uremia patients under peritoneal dialysis. Methods Forty uremia patients who the first entered peritoneal dialysis were divided into two groups: standard calcium concentration group (20 cases), low calcium concentration group (20 cases). Treated with continuous ambulatory peritoneal dialysis (CAPD), combining with oral calcium carbonate, observing 12 months. Results When the first entering CAPD, serum calcium, phosphorus, calcium-phosphorus product, immunoreactive parathyroid hormone (iPTH) of the two groups had no differences. Hyperphosphatemia, lower iPTH were universal. After 6 months' treatment, hypercalcemia and hyperphosphatemia in standard calcium concentration group got increasingly serious.While in low calcium concentration group, serum calcium, phosphorus, calcium-phosphorus product all decreased significantly, moreover, they were also lower than post-treatment standard calcium concentration group(P<0.01). In the following 6 months, in low calcium concentration group,serum calcium, calcium-phosphorus product maintained at the normal level serum phosphorus also decreased to the normal level iPTH maintained about 150 ng/L. During the treatment, all patients had no hypotension and hyperspasmia. Conclusion Low calcium concentration peritoneal dialysate can ameliorate disorder of calcium-phosphorus metabohsm, delay the appearance of its comphcations. Key words: Peritoneal dialysis; Calcium; Phosphorus; Parathyroid hormone; Calcium-phosphorus product