Christenson M, Fivush B, Racusen L
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Adv Perit Dial. 1992;8:15-7.
Hypocalcemia can be a significant problem for the patient with end stage renal disease (ESRD). Although oral calcium supplementation and activated vitamin D therapy may be successful in normalizing serum calcium levels, occasional peritoneal dialysis patients have persistent and clinically significant hypocalcemia. Several researchers have successfully utilized intraperitoneal calcium therapy (ICT) for the treatment of this abnormality. In order to evaluate whether high calcium dialysate is well tolerated, we developed a model system of ICT in Sprague Dawley rats. These rats received intraperitoneal infusion with either normal or high calcium peritoneal dialysate. Studies in this experimental rodent model showed no evidence of adverse effects of high calcium dialysate when used for up to 71 days, except for unexplained weight loss in the high calcium group. ICT can be an important adjunct in the treatment of hypocalcemia seen in patients on peritoneal dialysis. This preliminary animal study supports its clinical use. However further long term studies in animal models will be necessary to establish the long term safety of this therapy.
低钙血症对于终末期肾病(ESRD)患者而言可能是一个重大问题。尽管口服补钙和活性维生素D治疗或许能够成功使血清钙水平恢复正常,但部分腹膜透析患者仍会出现持续性且具有临床意义的低钙血症。一些研究人员已成功运用腹腔内补钙疗法(ICT)来治疗这一异常情况。为了评估高钙透析液的耐受性是否良好,我们在斯普拉格-道利大鼠中建立了一个ICT模型系统。这些大鼠接受腹腔内注入正常钙或高钙腹膜透析液。在这个实验性啮齿动物模型中的研究表明,高钙透析液使用长达71天未见不良反应迹象,不过高钙组出现了不明原因的体重减轻。ICT可作为治疗腹膜透析患者低钙血症的一项重要辅助手段。这项初步的动物研究支持其临床应用。然而,有必要在动物模型中开展进一步的长期研究,以确定该疗法的长期安全性。