Renal Osteodystrophy in Continuous Ambulatory Peritoneal Dialysis

CAPD appears to achieve adequate control of serum phosphate and of histological renal osteodystrophy with declining levels of PTH. However, 25 OHD levels are low and patients may need cautious Vitamin D replacement therapy. Calcium balance needs to be studied in greater detail and the correct PD fluid calcium concentration needs to be worked out; PD fluid calcium concentration of 1.5 mmol/1 is too low. It seems that, initially, calcium supplements by mouth are necessary. Serum aluminum levels appear to be elevated in those CAPD patients, who are not exposed to aluminium containing phosphate binders and it has not been determined whether this is related to peritoneal dialysis fluid aluminium content. It is essential, however, to minimise aluminium contamination of PD fluid.