October 17, 1966

Increased Calcium Content Suggested For Dialysis Bath

JAMA. 1966;198(3):46. doi:10.1001/jama.1966.03110160020010

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Metabolic bone disease is frequently seen in patients on a chronic dialysis program.

At the University Hospital and Artificial Kidney Center, Seattle, bone demineralization is a complication in 11 of 26 dialysis patients. Significant disability has occurred, at least transiently, in five of the affected individuals, Frederick C. Curtis, MD, told the Third International Congress of Nephrology.

These patients apparently absorb a relatively small percentage of an already low dietary calcium load, and do not absorb enough calcium during dialysis to compensate for a negative diet-stool balance.

(In Seattle, patients treated by chronic dialysis are dialysed 10 to 35 hours a week using a modified Kiil dialyzer. They consume a low protein diet containing approximately 500 mg/day of calcium. Vitamin D supplement is not routinely given.)

Persistent parathyroid hyperactivity, despite high normal serum calcium levels, appears to be an etiological factor in some patients; in others, the condition resembles idiopathic