[ Summary ] |
Low calcium dialysates for peritoneal dialysis, with calcium concentrations of 2.5mEq/l or less, are now prescribed more often than standard solutions when calcium concentrations are 3.5mEq/l or higher. This has come about since calcium containing phosphate binders and active vitamin D analogs have widely come into use. Theoretically, calcium absorbed through the gastro-intestinal tract is removed by peritoneal dialysis with low calcium dialysates. However, parathyroid hormone secretion is stimulated if hypocalcemia is not sufficiently treated by supplement of a calcium containing phosphate binder or an active vitamin D analog. The calcium balance of peritoneal daialysis patients will generally tend to be negative, if sevelamer hydrochroride and calcimimetics are used. We must find adequate calcium concentrations for peritoneal dialysis solutions for the greater majority of end-stage renal failure patients. |