Clinical Studies On Effect Of Different Calcium Concentrations Of Peritoneal Dialysate On Calcium And Phosphorus And Serum Intact Parathyroid Hormone

Objective: To investigate the effect of different dialysate calcium concentrations oncalcium and phosphorus and serum intact parathyroid hormone.Methods: A retrospective analysis comparing the indicators of serum calcium,phosphorus and intact parathyroid hormone (iPTH) in peritoneal dialysis patients whoreceived the treatment of peritoneal dialysate with a calcium concentration of1.75mmol/l of (PD2group) before August2011and that with a calcium concentration of1.25mmol/l (PD4group) after August2011. Firstly, according to the duration of usingPD2dialysate, the subjects were divided into group A (less than1year), group B (1to3years) and group C (more than3years). Serum calcium, phosphorus, and iPTH levels ofthe three groups were compared before and after using PD2and then after using PD4dialysate. Secondly, the serum calcium levels of the patients were compared before andafter using PD2and PD4dialysate. Serum calcium standardization rate, incidence ofhypercalcemia, and incidence of hypocalcemia were calculated.Results:1. The serum calcium, phosphorus and iPTH in patients were significantlyincreased (P <0.05) after using PD2dialysate.2. The serum phosphorus of group Cusing PD4dialysate who used PD2dialysate more than3years was significantly higher(P <0.05).3. After using PD2dialysate dialysis, the standardization rate of serumcalcium was not statistically significant compared with that of pre-dialysis (P>0.05),and the incidence of hypocalcemia was statistically significantly decreasing comparedwith that of pre-dialysis (P <0.05),and the incidence of hypercalcemia was statisticallysignificantly increasing compared with that of pre-dialysis (P <0.05).4. After using PD4dialysate, the standardization rate of serum calcium was statistically significantlyincreasing compared with that of pre-dialysis (P <0.05), and the incidence of hypocalcemia statistically significantly reduced compared with that of pre-dialysis (P<0.05), and the incidence of hypercalcemia changed remarkably compared with that ofpre-dialysis (P>0.05).Conclusion:1. Using PD2peritoneal dialysate could help to correct hypocalcemia, butit increased the incidence of hypercalcemia.2. Using PD4dialysate could help to increase the standardization rate ofserum calcium.3. With increase in the duration of dialysis, serum phosphorus graduallyincreased. Hyperphosphatemia and high serum PTH could not be corrected even withPD2and PD4dialysate use.