EFFECT OF TREATMENT WITH 1.25 AND 1.75 MMOL L CALCIUM DIALYSATE ON BONE-MINERAL DENSITY IN HEMODIALYSIS-PATIENTS/

The effect of two different dialysate solutions with a calcium concent ration of 1.25 and 1.75 mmol/l was evaluated in 14 patients, using a c ross-over design. Patients were treated with each solution during a pe riod of 6 months. Treatment with calcium supplements, vitamin D and al uminium hydroxide was adapted weekly, according to the results of bloo d chemistry. PTH, SAP, and ionized calcium were determined monthly, bo ne density with DXA and QCT before and after 6 months of treatment. Du ring treatment with both 1.25 and 1.75 calcium dialysate (cad), the co ntrol of serum calcium and phosphate was similar. PTH did not change d uring either treatment. SAP decreased during treatment with 1.75, but remained stable with 1.25 mmol/l cad. Bone density evaluated with DXA remained unchanged during both treatments. QCT measured bone density i ncreased from 101.29 +/- 13.50 to 106.79 +/- 13.14 mg/ml in the 1.75 c ad group, while it did not vary in the 1.25 cad group, (107.75 +/- 13. 48 versus 108.97 +/- 13.40 mg/ml). It is concluded that lowering the c alcium content of the dialysate does not negatively influence the cont rol of serum calcium and phosphate, nor does it aggravate hyperparathy roidism when vitamin D is administered simultaneously. Under the prese nt conditions, osteopenia and possibly bone mineralization improve onl y in the group dialysed with 1.75 Ca.