CALCIUM AND PHOSPHORUS RETENTION IN THE PRETERM INFANT DURING TOTAL PARENTERAL-NUTRITION - A COMPARATIVE RANDOMIZED STUDY BETWEEN ORGANIC AND INORGANIC-PHOSPHATE AS A SOURCE OF PHOSPHORUS

The preterm infant fed parenterally is prone to some demineralisation due in part to insufficient Calcium (Ca) and Phosphorus (P) retention. In an attempt to augment Ca and P retention, we prepared a standardis ed parenteral solution containing calcium gluconate and glucose-1-phos phate (Phocytan) as source of phosphorus, yielding a daily supply of 7 5 mg/kg Ca and 45 mg/kg P. 28 very low birthweight infants were random ly assigned to receive either this solution (high Ca/P; n = 15) or a c onventional formulation containing calcium gluconate and potassium mon o- and dibasic phosphate delivering 42 mg/kg Ca and 36 mg/kg P daily ( low Ca/P; n = 13). In the high Ca/P daily retention was respectively 8 0% and 99% for Ca and P whereas in the low Ca/P group, retention was 7 0% and 82%. Serum parathormone levels were significantly lower in the high Ca/P group. We conclude that parenteral nutrition with a new high Ca/P supplement results in an augmented Ca and P retention in very lo w birthweight infants. This may help to prevent neonatal bone deminera lization.