The Study On The Effect Of Low Calcium Dialysate On Calcium Phosphorus Metabolism, Left Ventricular Function And Arterial Compliance In CAPD Patients

Objective: To investigate the effect of low calcium dialysate on calcium and phosphorus metabolism,left ventricular function and arterial compliance in continuous ambulatory peritoneal dialysis(CAPD) patients with high or normal serum calcium,and provide a optimal treatment for those patients.Method: Thirty-three CAPD patients (standard cacium dialysate,calcium carbonate intake 2.56±0.51g/d) with high or normal serum calcium (corrective serum calcium >2.12 mmol/L,iPTH<150 pg/ml) were selected in this study.Standard calcium dialysate solution (1.75 mmol/L) was changed to lower calcium dialysate (Baxter PD4 with calcium concentration 1.25 mmol/L).Calcium carbonate (3g/d) was used at the meantime. The serum levels of calcium, phosphorus, albumin, alkaline phosphatease, natrium, kalium, creatinine (Scr), blood urea nitrogen (BUN), hemachrome,TC, TG, LDL, intact parathyroid hormone (iPTH) were detected periodically at 0, 4th, 8th, 12th week. The left ventricu1ar function and arterial compliance were echocardiographically examined at the same time.Results: After changing to PD4 , serum calcium,phosphorus concentration and calcium phosphorus product decreased,serum iPTH increased significantly but maintained an acceptable level afterwards.The changes in E/Amax,isovolumic relaxation time and arterial compliance were statistically significant after 8th week. The changes in serum calcium(8th,12th week) was a variable correlating with the simultaneous changes in E/Amax (r=0.39,Ρ<0.05;r=0.36,Ρ<0.05),IVRT (r=0.49,Ρ<0.05; r=0.42,Ρ<0.05) and AC (r=0.44,Ρ<0.05; r=0.38,Ρ<0.05). The changes in serum calcium phosphorus product (12th week) was another variable correlating with the simultaneous changes in IVRT (r=0.44,Ρ<0.05) and AC (r=0.47,Ρ<0.05). The changes in serum phosphorus (12th week) was also a variable correlating with the simultaneous changes in AC (r=0.52,Ρ<0.05).Conclusion: There were favorable changes in serum calcium,phosphorus and calcium phosphorus product in CAPD patients with high or normal serum cacium after treatment with low calcium dialysate and adequate calcium carbonate intake. As a result,the left ventricular function and AC were improved in those patients.