The results of nonrandomized retrospective studies have suggested that
low calcium dialysate (LCD; ionized calcium concentration 1.25 mmol/L
) is associated with a higher peritonitis rate than traditional dialys
ate (TD; ionized calcium concentration 1,75 mmol/L). For this reason,
86 consecutive new continuous ambulatory peritoneal dialysis patients
were randomized, in a single-blind fashion, to TD or LCD for 1 year. T
he results were analyzed on an intention-to-treat basis, no matter wha
t fluid or what modality of treatment was being used at the end of the
year. The two groups were well matched at baseline. At 1 year, 28 of
43 TD patients were still on continuous ambulatory peritoneal dialysis
(one had a catheter changed due to peritonitis), four had a working t
ransplant, one had recovered renal function, nine had died, and one ha
d been transferred to hemodialysis because of peritonitis. Twenty-seve
n of 43 LCD patients were on continuous ambulatory peritoneal dialysis
(one catheter change), nine had a working transplant, six had died, a
nd one was on hemodialysis, There were 17 proven (33 possible) periton
itis episodes in 417 patient-months in the TD group, In the LCD group,
there were 17 (35 possible) episodes in 432 patient-months, The prove
n peritonitis rate was 0.49 episodes/patient/yr in the TD group versus
0.48 episodes/patient/yr in the LCD group (P = NS), In conclusion, th
ere is no controlled evidence that LCD is associated with a higher inc
idence of peritonitis than TD. (C) 1995 by the National Kidney Foundat
ion, Inc.