| Theme |
Hypoparathyroidism and Related Problems in Dialysis Patients |
| Title |
Parathyroid function in uremic patients undergoing CAPD |
| Author |
Takashi Shigematsu |
Division of Nephrology, Department of Internal Medicine, Jikei University School of Medicine |
| Author |
Yoshindo Kawaguchi |
Division of Nephrology, Department of Internal Medicine, Jikei University School of Medicine |
| [ Summary ] |
Several reports have suggested that hypoparathyroidism with low bone turnover is more prevalent in uremic patients undergoing CAPD than in HD patients. The typical low bone turnover is an adynamic bone disease. The following factors are considered to account for hypoparathyroidism with low bone turnover, a positive calcium balance due to Ca and calcitriol supplementation, loss of PTH into the dialysate and continuous dextrose loading. We evaluated the effect of a low Ca (1.25mmol/l) dialysate on parathyroid function in hypoparathyroid CAPD patients. Serum calcium was decreased 0.25mmol/l without a concomitant serum phosphate elevation. The PTH level was increased within 3 months, and remained the constant thereafter. The low Ca dialysate has some beneficial effects for hypoparathyroidism with low bone turnover in uremic patients undergoing CAPD. However, the progression of secondary hyperparathyroidism and bone mineral loss should be prevented by adequate vitamin D and/or calcium supplementation. |