STOCKHOLM—Contrary to prevailing belief, patients on peritoneal dialysis (PD) have a higher phosphorus burden than do patients on hemodialysis (HD).


“Both a higher dietary intake and an inferior clearance contribute to the increased phosphorus exposure in PD patients,” researchers reported.

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Pieter Evenepoel, MD, and his colleagues at the University Hospital Gasthuisberg in Leuven, Belgium, based their findings on a study of 79 HD and 61 PD patients.


Time-averaged serum phosphorus levels in the HD patients (3.5 mg/dL) were significantly lower than the mid-day concentration in the PD group (5.0 mg/dL). Compared with HD patients, PD patients had higher concentrations of biointact parathyroid hormone (119 vs. 82 ng/L) and fibroblast growth factor 23 (10,334 vs. 5,075 ng/L), a key molecule involved in the regulation of phosphate homeostasis.


“Serum phosphorus targets should be adjusted downwards in PD patients,” the investigators concluded.


They reported findings here at the European Renal Association-European Dialysis and Transplant Association 2008 congress.