Prevention of renal osteodystrophy in peritoneal dialysis

Weinreich, Thomas

doi:10.1046/j.1523-1755.1998.00182.x

Cited by 21 publications

(17 citation statements)

References 47 publications

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“…In contrast, however, removal of insulin from cultured bovine parathyroid cells reduces PTH secretion [69]. It has also been suggested [70]that advanced glycolysation end products (AGEs) reduce the osteoblast response to regulatory hormones and cytokines. The possibility therefore exists that hyperglycemia contributes to the development of ABD, and that PD, with its associated increased glucose load and hyperinsulinemia, is a pathogenic factor.…”

Section: An Iatrogenic Disease?mentioning

confidence: 99%

Causes and Consequences of Adynamic Bone Disease

Heaf¹

2001

Nephron

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Section: An Iatrogenic Disease?mentioning

confidence: 99%

Causes and Consequences of Adynamic Bone Disease

Heaf¹

2001

Nephron

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“…Hemodialysis patients undergo rapid and intermittent removal of phosphate, uremic toxins and excess body fluid from sera, and influx or efflux of Ca influent in such metabolism [1–3]. Higher serum Ca levels and continuous glucose loading occur, which may lead to a higher incidence of adynamic bone in CAPD patients compared with that in HD patients [4, 5]. Patients with very low parathyroid hormone (PTH) level had a higher mortality rate after adjustment for age, gender, diabetes, and dialysis vintage [6].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with very low parathyroid hormone (PTH) level had a higher mortality rate after adjustment for age, gender, diabetes, and dialysis vintage [6]. The turnover of bone remodeling in PD patients is lower than that in HD patients [4, 5]. Using 3.5 mEq/L Ca dialysate in HD, Ca removal demonstrated a negative balance [7, 8].…”

Section: Introductionmentioning

confidence: 99%

Transperitoneal Calcium Balance in Anuric Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis Patients

Hamada

Tomino

2013

International Journal of Nephrology

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Backgrounds. Calcium (Ca) and bone metabolism in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis (HD) patients show a remarkable difference depending on dialysis modalities. The levels of serum Ca and phosphate (P) in HD patients fluctuate contributing to the intermittent and rapid removal of plasma solute unlike in CAPD. Characteristics of plasma solute transport in automated peritoneal dialysis (APD) patients are resembled with that in HD. The purpose of the present study was to examine the difference of transperitoneal Ca removal between APD and CAPD anuric patients. Subjects and Methods. Twenty-three APD anuric patients were enrolled in this study. Biochemical parameters responsible for transperitoneal Ca removal in 24-hour and 4-hour peritoneal effluents were analyzed on CAPD and APD. Results. Transperitoneal Ca removal on APD was smaller compared with that on CAPD. The Ca removal was related to the ultrafiltration during short-time dwell. Decrease of the Ca removal during NPD induced by short-time dialysate dwell caused negative or small Ca removal in APD patients. The levels of intact PTH were increased at the end of PET. Conclusion. It appears that short-time dwell and frequent dialysate exchanging might suppress the transperitoneal Ca removal in anuric APD patients.

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“…Conventional, lactate-based PD solutions do not fully correct metabolic acidosis, and they determine a loss of bicarbonate into the dialysate [52]. The development of new bicarbonate-based PD solutions should improve treatment and prevention of renal bone disease, by better correcting metabolic acidosis [53].…”

Section: Effect Of Metabolic Acidosis On Bone Metabolism In Pd Patienmentioning

confidence: 99%

Calcium and Phosphate Handling in Peritoneal Dialysis

Cozzolino¹,

Gallieni²,

Chiarelli³

et al. 2006

Contributions to Nephrology

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In the last 10 years, it has been well documented that mineral metabolism abnormalities in dialysis patients are associated with an enhanced risk of morbidity and mortality for cardiovascular disease. Extraskeletal calcifications represent one of the major risk factors involved in the pathogenesis of cardiovascular disease in this population. In fact, secondary hyperparathyroidism and hyperphosphatemia associate with increased cardiovascular mortality in uremic patients for two reasons: first for the passive deposition of calcium and phosphate in soft tissues; second for the active role of inorganic phosphate on direct induction of extraskeletal mineralization of the tunica media in the vasculature of these patients. In peritoneal dialysis patients, many unbalances of calcium and phosphate metabolism are present. In particular, recent cohort studies indicate that most patients do not reach targets indicated by clinical practice guidelines. Further efforts to control hyperphosphatemia are essential, in order to reduce the impact of secondary hyperparathyroidism both on bone and cardiovascular system.

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Prevention of renal osteodystrophy in peritoneal dialysis

Cited by 21 publications

References 47 publications

Causes and Consequences of Adynamic Bone Disease

Causes and Consequences of Adynamic Bone Disease

Transperitoneal Calcium Balance in Anuric Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis Patients

Calcium and Phosphate Handling in Peritoneal Dialysis

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