eprintid: 10167473 rev_number: 9 eprint_status: archive userid: 699 dir: disk0/10/16/74/73 datestamp: 2023-03-30 10:22:07 lastmod: 2023-03-30 10:22:07 status_changed: 2023-03-30 10:22:07 type: article metadata_visibility: show sword_depositor: 699 creators_name: Davenport, A title: Calcium balance in peritoneal dialysis patients treated by continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) cyclers ispublished: inpress divisions: UCL divisions: B02 divisions: C10 divisions: D17 keywords: Calcium, DXA, Gender, Osteoporosis, Peritoneal dialysis, Phosphate binders, Ultrafiltration, Urinary calcium note: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. abstract: Introduction: Although vascular calcification is a recognised complication for haemodialysis patients, peritoneal dialysis (PD) patients are also at risk. As such we wished to review peritoneal and urinary calcium balance and the effect of calcium containing phosphate binders (CCPBs). Methods: Twenty-four-hour peritoneal calcium balance and urinary calcium were reviewed in PD patients undergoing their first assessment of peritoneal membrane function. Results: Results from 183 patients, 56.3% male, 30.1% diabetic, mean age 59.4 ± 16.4 years, median 2.0 (2–6) months of PD, 29% treated by automated PD (APD), 26.8% continuous ambulatory (CAPD) and 44.2% APD with a day-time exchange (CCPD) were reviewed. Peritoneal calcium balance was positive in 42.6%, and remained positive in 21.3% after including urinary calcium losses. PD calcium balance was negatively associated with ultrafiltration (odds ratio 0.99 (95% confidence limits 0.98–0.99), p = 0.005. PD calcium balance was lowest with APD (APD − 0.45 (− 0.78 to 0.05) vs CAPD − 0.14 (− 1.18 to 0.59) vs CCPD − 0.03) − 0.48 to 0.5) mmol/day), p < 0.05, with 82.1% of patients with a positive balance prescribed icodextrin, when combining peritoneal and urinary losses. When considering CCPB prescription, then 97.8% of subjects prescribed CCPD had an over-all positive calcium balance. Discussion: Over 40% of PD patients had a positive peritoneal calcium balance. Elemental calcium intake from CCPB had a major effect on calcium balance, as median combined peritoneal and urinary calcium losses were < 0.7 mmol/day (26 mg), so caution is required to prevent excessive CCPB prescribing, increasing the exchangeable calcium pool and thus potentially increasing vascular calcification, particularly for anuric patients. Graphical abstract: [Figure not available: see fulltext.] date: 2023-01-01 date_type: published publisher: Springer Science and Business Media LLC official_url: https://doi.org/10.1007/s40620-023-01575-2 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2010352 doi: 10.1007/s40620-023-01575-2 medium: Print-Electronic pii: 10.1007/s40620-023-01575-2 lyricists_name: Davenport, Andrew lyricists_id: ADAVE78 actors_name: Davenport, Andrew actors_name: Henderson, Kathryn actors_id: ADAVE78 actors_id: KJHEN38 actors_role: owner actors_role: impersonator full_text_status: public publication: Journal of Nephrology event_location: Italy issn: 1121-8428 citation: Davenport, A; (2023) Calcium balance in peritoneal dialysis patients treated by continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) cyclers. Journal of Nephrology 10.1007/s40620-023-01575-2 <https://doi.org/10.1007/s40620-023-01575-2>. (In press). Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10167473/2/Davenport_s40620-023-01575-2.pdf