of 3.5 mEq/L (1.75 mmol/L). This concentration is equal to or slightly greater than the ionized concentration in the serum of most patients. As a result, there is net calcium absorption in most patients treated with a conventional chronic ambulatory peritoneal dialysis regimen. As the use of calcium-containing phosphate binders has increased, hypercalcemia has become a common problem when utilizing the 3.5 mEq/L calcium dialysate. This complication has been particularly common in patients treated with peritoneal dialysis, since they have a much greater incidence of adynamic bone disease than do hemodialysis patients [27]. In fact, the continual positive calcium balance associated with the 3.5-mEq/L solution has been suggested to be a contributing factor in the development of this lesion. The low bone turnover state typical of this disorder impairs accrual

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