Calcium mass transfer in peritoneal dialysis patients using 2.5 mEq/l calcium dialysate

B. Piraino, J. Bernardini, J. Holley, J. R. Johnston, J. A. Perlmutter, L. Martis

Research output: Contribution to journalArticlepeer-review

Abstract

Standard peritoneal dialysate has a relatively high calcium concentration of 3.5 mEq/l. Peritoneal dialysis patients thus gain calcium from the dialysate which contributes to the risk of hypercalcemia. Dialysate with 2.5 mEq/l calcium is now available. Theoretically, using dialysate with this calcium content, calcium transfer should be negative (from the patient into the dialysate) when the patient is hypercalcemic, and positive when the patient is normocalcemic or hypercalcemic. Thus, 2.5 mEq/l calcium dialysate may allow larger doses of calcium carbonate to be prescribed. We compared calcium mass transfer (CMT) in 17 stable peritoneal dialysis patients using 3.5 and 2.5 mEq/l calcium dialysate. A solution of 2.05 l, 1.5 g/dl dextrose was dwelled for 4 hours. Calcium was measured in the drained dialysate and serum (total and ionized). Mean CMT was 0.7 ± 0.5 mEq/exchange using 3.5 mEq/l calcium dialysate and -0.9 ± 0.9 mEq/exchange using 2.5 mEq/l calcium dialysate (p <0.0001). At the time of the CMT studies, the mean serum ionized calcium levels were identical for the two groups (2.6 mEq/l). CMT correlated inversely with serum total calcium, serum ionized calcium, and drained dialysate volume. During hypercalcemia calcium transfer was from the dialysate to the patient when 3.5 mEq/l calcium dialysate was used, but from the patient to the dialysate when 2.5 mEq/l calcium dialysate was used. We conclude that 2.5 mEq/l calcium dialysate is effective in removing calcium and will be helpful in preventing hypercalcemia when large doses of oral calcium compounds are prescribed as a phosphate binder.

Original languageEnglish (US)
Pages (from-to)48-51
Number of pages4
JournalClinical Nephrology
Volume37
Issue number1
StatePublished - Jan 1 1992
Externally publishedYes

Keywords

  • Calcium mass transfer
  • Hypercalcemia
  • Peritoneal dialysis
  • Renal osteo-dystrophy

ASJC Scopus subject areas

  • Nephrology

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