Calcium balance during pulse alfacalcidol therapy for secondary hyperparathyroidism in CAPD patients treated with 1.0 and 1.25 mmol/L dialysate calcium
A. Chagnac et al., Calcium balance during pulse alfacalcidol therapy for secondary hyperparathyroidism in CAPD patients treated with 1.0 and 1.25 mmol/L dialysate calcium, AM J KIDNEY, 33(1), 1999, pp. 82-86
Hypercalcemia frequently occurs in continuous ambulatory peritoneal dialysi
s (CAPD) patients treated with calcium carbonate and vitamin D metabolites.
To reduce the incidence of this complication, it has been proposed to use
dialysate solutions with a low calcium concentration. However, there is con
cern that these solutions may lead to a negative calcium balance. We measur
ed calcium balance in 13 CAPD patients with secondary hyperparathyroidism w
ho were treated with calcium carbonate and alfacalcidol, 2 mu g twice weekl
y, while using 1.0- (1.0 group) and 1.25-mmol/L (1.25 group) dialysate calc
ium solutions, Calcium absorption was measured after the administration of
Ca-47. Results for the 1.0 (n = 6) and 1.25 (n = 7) groups included fractio
nal calcium absorptions of 0.14 (range, 0.09 to 0.27) and 0.08 (range, 0.03
to 0.40; P = not significant [NS]) and calcium absorptions of 380 +/- 92 a
nd 331 +/- 83 mg/d (P = NS). Dialysate calcium losses were 93 +/- 20 and 91
+/- 26 mg/d, and total calcium losses (dialysate and urine) were 106 +/- 1
6 and 108 +/- 40 mg/d (P = NS), Calcium balance was positive in all patient
s (274 +/- 92 and 223 +/- 65 mg/d; P = NS). These data suggest that the use
of 1.0- and 1.25-mmol/L calcium solutions in conjunction with calcium carb
onate and pulse alfacalcidol therapy is associated with a positive calcium
balance in CARD patients. (C) 1999 by the National Kidney Foundation, Inc.