Abstract
Backgrounds. Calcium (Ca) and bone metabolism in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients show a remarkable difference depending on dialysis modalities. The levels of serum Ca and phosphate (P) in HD patients fluctuate contributing to the intermittent and rapid removal of plasma solute unlike in CAPD. Characteristics of plasma solute transport in automated peritoneal dialysis (APD) patients are resembled with that in HD. The purpose of the present study was to examine the difference of transperitoneal Ca removal between APD and CAPD anuric patients. Subjects and Methods. Twenty-three APD anuric patients were enrolled in this study. Biochemical parameters responsible for transperitoneal Ca removal in 24-hour and 4-hour peritoneal effluents were analyzed on CAPD and APD. Results. Transperitoneal Ca removal on APD was smaller compared with that on CAPD. The Ca removal was related to the ultrafiltration during short-time dwell. Decrease of the Ca removal during NPD induced by short-time dialysate dwell caused negative or small Ca removal in APD patients. The levels of intact PTH were increased at the end of PET. Conclusion. It appears that short-time dwell and frequent dialysate exchanging might suppress the transperitoneal Ca removal in anuric APD patients.
Highlights
Bone disease is one of the serious complications in chronic dialysis patients
It is generally considered that Ca and bone metabolism between peritoneal dialysis (PD) and hemodialysis (HD) patients provided remarkable differences according to dialysis modalities
We demonstrated that transperitoneal Ca removal in automated peritoneal dialysis (APD) patients without residual renal function was smaller, compared with that in continuous ambulatory peritoneal dialysis (CAPD) patients
Summary
Bone disease is one of the serious complications in chronic dialysis patients. Adynamic bone disease and secondary hyperparathyroidism are associated with viability and quality of life (QOL) and mortality in long-term dialysis patients. It is generally considered that Ca and bone metabolism between peritoneal dialysis (PD) and hemodialysis (HD) patients provided remarkable differences according to dialysis modalities. It is recognized that Ca mass transport in CAPD patients depends on the following factors: Ca concentration in the dialysis fluid, starting plasma Ca and P concentrations, and ultrafiltration, which removes the nonprotein bound diffusible calcium [9,10,11,12]. Characteristics of plasma solute transport in patients with automated peritoneal dialysis (APD) are resembled with that of HD. It is postulated that a shorttime dwell of peritoneal dialysate may lead to differences in the transperitoneal Ca balance and PTH secretion between APD and CAPD patients
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