The Effects Of Physiological Calcium Peritoneal Dialysis On The Disorders Of Serum Calcium And Phosphorus And Vascular Calcification

Objective:To investigate the calcium and phosphorus metabolism and cardiovascular system in patients using physiological calcium peritoneal dialysate.Methods:A total of 134 peritoneal dialysis patients who has been followed-up more than 12 months were divided into high calcium dialysis group and physiological calcium dialysis group according to the types of dialysate they used.After 12 months of treatment,the general situation,serum levels of calcium and phosphorus and the indices of cardiac ultrasound and vascular calcification were compared between two groups.Results:1.A total of 134 patients were enrolled in this study,including 76 patients with high calcium dialysis and 58 patients with physiological calcium dialysis.The average age of the patients was(50.0 ± 18.9)years,the ratio of male to female was 1.34:1,including 72 cases(56.6%)of glomerulonephritis,22 cases(15.9%)of diabetic nephropathy,4 cases(2.63%)of polycystic kidney disease,8 cases(5.26%)of lupus nephritis,28 casesof hypertension nephropathy(19.7%).2.After 12 months of treatment,the serum calcium level in high calcium dialysis group was significantly higher than that in another group(P<0.01).3.The increments of serum calcium,calcification scores of coronary arteries and abdominal aorta were more prominent in the high calcium dialysis group than those in physiological calcium dialysis group(P<0.01).4.As compared with the patients in high calcium group,those in physiological calcium group and the five patients who have changed to use physiological calcium dialysate had the higher proportions of vitamin D administration and ideal serum calcium level(P<0.05).5.For the 5 patients who have changed their dialysates from high calcium to physiological calcium,the 12-month treatment of physiological calcium dialysate made them serum calcium significantly decreased and the parathyroid hormone level markedly increased(P<0.01).6.The patients who were previously dialyzed by high calcium dialysate experienced an higher ideal serum parathyroid hormone level after 12-month treatment with physiological dialysate(P<0.05).Conclusions:Physiological calcium dialysate are helpful for the patients in maintaining ideal serum calcium and parathyroid hormone levels,and retarding the aggregation of vascular calcification.