Skip Navigation



NDT Advance Access published online on April 6, 2004
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh214
© 2004 by European Renal Association - European Dialysis and Transplant Association
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
19/6/1587    most recent
gfh214v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Sánchez, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sánchez, C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Received October 28, 2003
Accepted February 13, 2004

Original Article

Low vs standard calcium dialysate in peritoneal dialysis: differences in treatment, biochemistry and bone histomorphometry. A randomized multicentre study

Carmen Sánchez 1*, Fernando López-Barea 2, Jesús Sánchez-Cabezudo 3, Auxiliadora Bajo 1, Alberto Mate 2, Eugenia Martínez 3, Rafael Selgas 4, for the Collaborators of the Multicentre Study Group

1 Department of Nephrology, University Hospital ‘La Paz’, Madrid, Spain
2 Department of Pathology, University Hospital ‘La Paz’, Madrid, Spain
3 Biochemical Division of University Hospital ‘La Paz’, Madrid, Spain
4 Nephrology Division of University Hospital ‘La Princesa’, Madrid, Spain

* To whom correspondence should be addressed. E-mail: csanchez.hulp{at}salud.madrid.org.



  Abstract

Background. In patients undergoing peritoneal dialysis (PD), low-calcium dialysate (LCD) has been proposed as the first choice for a better control of renal osteodystrophy. Our aim was to compare the effects on bone metabolism of LCD (calcium: 1.25 mmol/l) with that of a standard calcium dialysate (SCD; calcium: 1.75 mmol/l).

Methods. Forty-four PD patients were randomized to receive LCD or continue on SCD for a period of 12 months. Bone biopsies were taken at baseline and at 12 months. Biochemical data and treatment were evaluated every 3 months.

Results. Twenty-four patients completed the study. In the SCD group (n = 10), nine out of the 10 patients were initially diagnosed with adynamic bone lesion (ABL). After 1 year, six continued having ABL and three patients moved to high-turnover bone lesion (HTBL). The other patient, initially diagnosed with HTBL, changed to ABL. In the LCD group (n = 14), 10 patients were initially diagnosed with ABL. At 1 year, six of them continued having ABL and four patients changed to HTBL. Four patients were initially diagnosed with HTBL and did not change. Comparison between LCD and SCD groups showed an increase in serum parathyroid hormone (PTH) levels starting at month 3 and a higher intake of calcium salts in the former group (P<0.01). Serum calcium, phosphate levels and bone histological outcome did not differ between the two groups.

Conclusions. LCD use for 1 year was associated with an increase in PTH levels, but did not lead to histological changes different from those observed in SCD group. The LCD solution allowed a higher oral intake of calcium salts with a satisfactory control of the serum Calcium-Phosphorus product.

Keywords: bone biopsy; bone histomorphometry; low-calcium dialysate; peritoneal dialysis; renal osteodystrophy; standard calcium dialysate


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.