Reversible peritoneal calcification in a patient treated by CAPD

The patient, a female, aged 65 years, developed diffuse peritoneal calcific ation nine years after commencing CAPD therapy. No abdominal symptoms or ev idence of peritonitis were discovered during this period. Before peritoneal calcification was detected, a dialysate with a high glucose cencentration (3.86%) had been used once daily for 16 months. In the case of this patient , it was not possible to discover any of the previous indicated etiologies of peritoneal calcification such as significantly elevated values for the p roduct Ca x P, overt secondary hyperparathyroidism, or relapsing peritoniti s. It was realized that the use of a high-glucose dialysate in a patient on long-term CAPD treatment had been one causative factor. After peritoneal c alcification had been confirmed, the calcium concentration of the dialysate changed from 3.5 mEq/l to 2.5 mEq/l and the patient was put on a regime of 2.0 g alumigel (aluminum-containing phosphate binders) a day. Eight months later, a CT scan was taken. The peritoneal calcification has clearly been mitigated. At present, CAPD therapy is being continued in the absence of an y abdominal symptoms.