Abstract: FR-PO142
Loss of PTH Circadian Secretion in Peritoneal Dialysis Patients: A Case Series
Session Information
- Bone and Mineral Metabolism: Phosphorus, FGF23, Vascular Calcification
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 401 Bone and Mineral Metabolism: Basic
Authors
- Martino, Francesca K., San Bortolo Hospital, Vicenza, Italy
- Amici, Gianpaolo, AAS3 Friuli Venezia Giulia, San Daniele del Friuli, Italy
- Giuliani, Anna, San Bortolo Hospital, Vicenza, Italy
- Crepaldi, Carlo, San Bortolo Hospital, Vicenza, Italy
- Ronco, Claudio, University of Padova, IRRIV, San Bortolo Hospital, Vicenza, Italy
Introduction
Chronic Kidney disease (CKD) affects calcium and phosphorus metabolism and in PTH secretion. Under normal conditions, PTH is secreted by parathyroid gland with circadian rhythm and can be influenced by calcium, phosphate and vitamin D levels. These factors find peculiar expression in peritoneal dialysis patients. We report PTH levels, serum calcium and phosphorus in six patients on peritoneal dialysis during the 24-hours period.
Case Description
In 6 patients, PTH, calcium and phosphorus were evaluated at the following times every 4 hours at 8 am o’clock, 12 am, 4 pm, 8 pm, middle night and 4 am (+ 1day) and 8 am (+ 1day). Some parameters related to peritoneal dialysis (such as type of dialysis, peritoneal solution) , hemoglobin, creatinine, sodium, and albumin levels were evaluated for each patient. Moreover, when present we described calcium, and phosphate urine excretion in 24 hours collection.
Patients characteristics are described in table 1.
In figure 1 are described the levels of PTH for each patient and in figure 2 the levels of calcium and phosphate for each patient.
Discussion
These clinical reports suggest the loss of circadian rhythm in PTH secretion in peritoneal dialysis patients.
Clinical and dialysis parameters
| Gender | Age (years) | type of dialysis | PERITONEAL SOLUTIONS | Ca bath (mmil/l) | Ultrafiltration/urine output (cc/d) | Hemoglobin (g/dl) | Na (mmol/l) | Albumin (g/dl) | U-Ca (mg/dl) | U-P(mg/dl) | LP-Ca (mg/dl) | LP-P (mg/dl) | |
| Patient1 | male | 30 | CAPD | 3 x 1.5% G daytime, Ico7.5% night-time | 1.75 | 1200/ 600 | 11.6 | 139 | 3.9 | 3.9 | 3.75 | 1.9 | 8.3 |
| Patient2 | female | 46 | APD | Ico 7.5% day-time 2 x 1.36% G+1 X 2.27% G night-time | 1.75 | 1050/400 | 9.2 | 139 | 3.3 | 4.6 | 9.5 | 4.5 | 6.4 |
| Patient3 | male | 60 | CAPD | 3 x 2.27% G day-time Ico 7.5% night-time | 1.25 day-time 1.75 night-time | 1200/0 | 10.8 | 130 | 3.2 | 3.45 | 2.87 | 0 | 0 |
| Patient4 | male | 53 | APD | 1 x 1.36% G+2 X 2.27% G night-time | 1.25 | 1280/0 | 9.4 | 132 | 2.6 | 2.35 | 3.05 | 0 | 0 |
| Patient5 | female | 66 | CAPD | 2 X 1.36 % G +1 x 2.27% day-time 2.27 % G night-time | 1.25 | 1240/800 | 10.1 | 144 | 3 | 2.15 | 1.77 | 1.9 | 14.8 |
| Patient6 | female | 62 | CAPD | 4 X 1.5% G | 1.75 | 800/0 | 11 | 133 | 3.1 | 1.7 | 1.52 | 0 | 0 |
G=glucose ;Ico=Icodestrin
PTH levels during 24 hours
Calcium and phosphate levels during 24 hours