Phosphorus control in peritoneal dialysis patients

Hyperphosphatemia is independently associated with an increased risk of death among dialysis patients. In this study, we have assessed the status of phosphate control and its clinical and laboratory associations in a large international group of patients on chronic peritoneal dialysis (PD) treatment. This cross-sectional multicenter study was carried out in 24 centers in three different countries (Canada, Greece, and Turkey) among 530 PD patients (235 women, 295 men) with a mean±s.d. age of 55±16 years and mean duration of PD of 33±25 months. Serum calcium (Ca2+), ionized Ca2+, phosphate, intact parathyroid hormone (iPTH), 25-hydroxy vitamin D3, 1,25-dihydroxy vitamin D3, total alkaline phosphatase, and bone alkaline phosphatase concentrations were investigated, along with adequacy parameters such as Kt/V, weekly creatinine clearance, and daily urine output. Mean Kt/V was 2.3±0.65, weekly creatinine clearance 78.5±76.6 l, and daily urine output 550±603 ml day−1. Fifty-five percent of patients had a urine volume of 55 mg2dl−2 in 136 patients (26%) and lower than 55 mg2dl−2 in 394 patients (74%). Serum phosphorus levels were positively correlated with serum albumin (P