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Low vs standard calcium dialysate in peritoneal dialysis: differences in treatment, biochemistry and bone histomorphometry. A randomized multicentre study.
Nephrol Dial Transplant. 2004 Jun; 19(6):1587-93.ND

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.

Authors+Show Affiliations

Department of Nephrology, University Hospital La Paz, Madrid, Spain . csanchez.hulp@salud.madrid.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

15069173

Citation

Sánchez, Carmen, et al. "Low Vs Standard Calcium Dialysate in Peritoneal Dialysis: Differences in Treatment, Biochemistry and Bone Histomorphometry. a Randomized Multicentre Study." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 19, no. 6, 2004, pp. 1587-93.
Sánchez C, López-Barea F, Sánchez-Cabezudo J, et al. Low vs standard calcium dialysate in peritoneal dialysis: differences in treatment, biochemistry and bone histomorphometry. A randomized multicentre study. Nephrol Dial Transplant. 2004;19(6):1587-93.
Sánchez, C., López-Barea, F., Sánchez-Cabezudo, J., Bajo, A., Mate, A., Martínez, E., & Selgas, R. (2004). Low vs standard calcium dialysate in peritoneal dialysis: differences in treatment, biochemistry and bone histomorphometry. A randomized multicentre study. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 19(6), 1587-93.
Sánchez C, et al. Low Vs Standard Calcium Dialysate in Peritoneal Dialysis: Differences in Treatment, Biochemistry and Bone Histomorphometry. a Randomized Multicentre Study. Nephrol Dial Transplant. 2004;19(6):1587-93. PubMed PMID: 15069173.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low vs standard calcium dialysate in peritoneal dialysis: differences in treatment, biochemistry and bone histomorphometry. A randomized multicentre study. AU - Sánchez,Carmen, AU - López-Barea,Fernando, AU - Sánchez-Cabezudo,Jesús, AU - Bajo,Auxiliadora, AU - Mate,Alberto, AU - Martínez,Eugenia, AU - Selgas,Rafael, AU - ,, Y1 - 2004/04/06/ PY - 2004/4/8/pubmed PY - 2004/9/24/medline PY - 2004/4/8/entrez SP - 1587 EP - 93 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 19 IS - 6 N2 - 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. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/15069173/Low_vs_standard_calcium_dialysate_in_peritoneal_dialysis:_differences_in_treatment_biochemistry_and_bone_histomorphometry__A_randomized_multicentre_study_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfh214 DB - PRIME DP - Unbound Medicine ER -