Low-calcium dialysate as a risk factor for decline in bone mineral density in peritoneal dialysis patients

Title
Low-calcium dialysate as a risk factor for decline in bone mineral density in peritoneal dialysis patients
Author(s)
도준영강석휘[강석휘]조규향박종원윤경우
Keywords
DISEASE; MULTICENTER; DIAGNOSIS; FRACTURE; MARKERS; SERUM; CAPD
Issue Date
201212
Publisher
INFORMA HEALTHCARE
Citation
SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY, v.46, no.6, pp.454 - 460
Abstract
Objective. Few studies have linked changes in bone mineral density (BMD) in peritoneal dialysis (PD) patients to the calcium concentration in peritoneal dialysate. Material and methods. In total, 236 incident patients who underwent an annual BMD determination for 2 years were enrolled. The patients were divided into two groups: the standard calcium dialysate (SCD) group (n = 190; 1.75 mmol/l) and the low-calcium dialysate (LCD) group (n = 46; 1.25 mmol/l). Results. There were no significant differences between the baseline demographics of the two groups, such as age, diabetes, calcium, phosphorus, alkaline phosphatase (ALP), intact parathyroid hormone (i-PTH) levels or variables related to BMD. Univariate and multivariate analyses [ adjusted for age, gender and time-averaged 25(OH)-vitamin D] determined that the LCD group had higher time-averaged i-PTH and ALP and a greater decrease in bone mineral content, lumbar spine BMD, subtotal BMD and total BMD compared to the SCD group. Conclusion. LCD is associated with a more rapid decline in BMD, higher i-PTH and higher ALP in PD patients. It is suggested that LCD be avoided for PD patients a trisk of osteoporosis and hyperparathyroidism.
URI
http://hdl.handle.net/YU.REPOSITORY/26762http://dx.doi.org/10.3109/00365599.2012.700643
ISSN
0036-5599
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의과대학 > 내과학교실 > Articles
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