Abstract
We tried to confirm whether the use of low-calcium dialysate may increase the dose of 1 alpha- hydroxyvitamin D3 (D) and consequently suppress parathyroid hormone secretion in hemodialysis (HD) patients (Pts) with secondary hyperparathyroidism (HP).
Randomized cross-over study was done in eight stable HD Pts with HP. Solubility of granulated dry-chemical dialysate, containing low-calcium (AKDD25, 2.5mEq/l) or conventional calcium (AKDD30, 3.0mEq/l), were checked by measuring their conductivity. They completely dissolved in 6min, which is comparable with conventional powder dry-chemical dialysate. Pts were dialyzed with AKDD25 and AKDD30 for twelve weeks each. Serum PTH levels significantly decreased during HD with AKDD25 comparing with AKDD30. The serum calcium concentrations were maintained within normal range. The dosage of 1, 25-dihydroxyvitamin D3 was significantly increased during AKDD25 comparing with AKDD30. Low-calcium dialysate facilitates sufficient supplement of vitamin D3, and is further effective to suppress PTH oversecretion in maintenance HD patients.
