MINERAL STATUS AND CALCIUM METABOLISM OF RENAL DISEASE PATIENTS UNDERGOING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (ABSORPTION, DIET, PHOSPHATE-BINDERS, FLUID)
Abstract
Serum, peritoneal dialysate, and urine contents of phosphorus, calcium, magnesium, aluminum, zinc, and copper were determined over a 6-month period in 10 renal disease patients on continuous ambulatory peritoneal dialysis (CAPD). Results indicated that serum phosphorus levels were on the high end of the normal range in CAPD patients who consumed aluminum-containing phosphate-binders. Compared to other studies, serum aluminum contents tended to be high in the CAPD patients. Serum calcium concentrations were normal to low. Serum levels of magnesium, zinc, and copper were all in the normal ranges. The dietary intakes of calcium, based on 24-hr recall, were low in the CAPD patients. However, the patients apparently absorbed significant amounts of calcium from the dialysis fluid. Little calcium was excreted in the urine by these patients. Daily excretion of phosphorus, magnesium, aluminum, zinc, and copper, calculated from the sum of urinary and dialysate values were lower than the daily urinary excretion of these minerals by normal persons. The rate of calcium-44 absorption was measured in three CAPD patients given two levels of calcium carbonate (CaCO(,3)) supplementation. In addition, the effects of calcium supplementation on status of calcium, phosphorus, magnesium, zinc, and copper was also investigated by examining the blood, peritoneal dialysate, urinary, and fecal contents of these minerals. The total amount of calcium absorbed tended to be higher when the higher-dose (HD) of CaCO(,3) was administered. Fecal and urinary calcium contents as well as estimated calcium balance increased with increased calcium intake. Plasma phosphorus levels were not changed by the calcium supplements. The higher fecal excretion of phosphorus in HD period indicated that CaCO(,3) acted as a phosphate-binder. Plasma levels of magnesium, zinc, and copper were all in the normal range. However, daily magnesium intake tended to be low, and fecal excretion of magnesium was enhanced by the high calcium intake.
Degree
Ph.D.
Subject Area
Nutrition
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