Histological renal osteodystrophy, and 25 hydroxycholecalciferol and aluminum levels in patients on continuous ambulatory peritoneal dialysis

Prevalence of 25(OH) Vitamin D Insufficiency and Deficiency in Pediatric Patients on Chronic Dialysis

“…Previous reports suggested that PD patients are at especially high risk and might need supplementation with ergocalciferol because of ongoing loss of vitamin D binding protein through peritoneal effluent (20,21,(29)(30)(31)(32). Our results are compatible with those in previous reports and might favor supplementation with ergocalciferol in addition to active vitamin D sterols in pediatric patients on chronic dialysis.…”

“…A possible explanation is loss of vitamin D binding protein through the peritoneal effluent in PD (29)(30)(31). In previous studies, vitamin D deficiency was proportionately much lower in HD patients than in PD patients (19,21).…”

“…Possible explanations for that finding include uremia, darker skin, and reduced sun exposure because of infirmity or dialysis modality. It is also known that suboptimal vitamin D status may be associated with the rate of progression of renal insufficiency (1)(2)(3)(4) (29)(30)(31)(32). Inadequate nutrition and low levels of vitamin D binding protein can play a role as contributing factors in CKD patients with low levels of serum albumin and vitamin D (16,19,32).…”

Comparison Between Continuous Ambulatory Peritoneal Dialysis and in Center Hemodialysis

“…However, the higher serum bicarbonate levels in CAPD patients indicate better control of the acidosis and this may have a good impact on the renal osteodystrophy, as was demonstrated by Gokal et al 8 There was no statistically significant difference in the mean hemoglobin value for the two groups. This is similar to what some observers have found, 9,10 but others 11,12 have reported a 5 to 7% increase in the average hematocrit readings at one year in patients initiated and maintained on CAPD.…”

Risk Factors and Consequences of Hyperaluminemia in a Peritoneal Dialysis Cohort

“…Toxicity because of excess Al can induce low-turnover osteomalacia, low levels of parathyroid hormone, anemia, microcytosis, and increased erythropoietin requirements (1,2). Such manifestations were commonly reported in the 1970s and 1980s in patients inadvertently exposed to low-level Al content in dialysates or receiving chronic therapy with Al-containing phosphate binders (1,(3)(4)(5)(6)(7). Symptoms that are more acute and apparent, such as encephalopathy and seizures, have historically been described with overt contamination of dialysate water (8,9).…”