[Chronic kidney disease (CKD) and bone. Management of chronic kidney disease-mineral and bone disorder in peritoneal dialysis patients].

The peritoneal dialysate calcium concentration is an important factor in chronic kidney disease-mineral and bone disorder (CKD-MBD), because dialysate calcium concentrations strongly influence the serum calcium, phosphate, and parathyroid hormone (PTH) levels and the dosage of phosphate binders/vitamin D analogs. High-calcium dialysate has been used to correct hypocalcemia in end-stage renal disease (ESRD). Subsequently, a low-calcium dialysate was produced to increase the dosage of calcium-containing phosphate binders and vitamin D analogs without causing hypercalcemia. However, not enough is known about the effect of low-calcium dialysate in peritoneal dialysis. When we choose low-calcium dialysate, we should keep the risks of deteriorating secondary hyperparathyroidism in mind.