Comparison of calcium and phosphorus homeostasis between hemodialysis and peritoneal dialysis in patients with end-stage renal disease

Introduction: Chronic kidney disease (CKD) and subsequent end-stage renal disease (ESRD) are public health problems worldwide, and their prevalence is increasing worldwide. Abnormalities in calcium and phosphorus are common problems that need to be considered alongside other important factors when choosing a dialysis method. Hence, the present study aimed to assess and compare the calcium and phosphorus homeostasis in ESRD patients on hemodialysis and peritoneal dialysis (PD).

Methods: In this descriptive cross-sectional study, 150 patients with ESRD on hemodialysis and 150 patients with ESRD on PD in the dialysis department of Imam Reza hospital of Tabriz University were selected randomly. The serum levels of calcium, phosphorus, and intact parathyroid hormone (iPTH) before the initiation of dialysis and one year afterward were considered for comparison.

Results: In the hemodialysis group, 33.1% of patients were female and 66.9% were male but in the PD group, sex distribution was 47% males and 53% females. Following one year of dialysis, mean calcium (Ca), phosphorus (P), and iPTH levels were significantly higher in the hemodialysis group compared to PD patients (P<0.05). Also, the mean Ca×P product was significantly higher in patients undergoing PD (P=0.05).

Conclusion: Our findings suggested that calcium, phosphorus and iPTH levels increase with prolonged hemodialysis rather than PD, and the rate of Ca×P in patients is significantly higher in PD patients after one year.