Dianeal Low‑Calcium with 1.5 % Dextrose – Overview
| Feature | Details |
|---------|---------|
| Brand | Dianeal |
| Indication | Continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD) in patients with chronic kidney disease (CKD). |
| Formulation | • 1.5 % dextrose (glucose) concentration (≈ 150 g/L).
• Low‑calcium (≈ 1.25 mmol/L, 5 mg/dL) to help control hypercalcemia and reduce the risk of dialysate‑induced hypocalcemia. |
| Common Uses | • Daily exchange in CAPD.
• Used in APD cycles where a lower glucose load is desired. |
| Packaging | • Standard 500 mL or 1 L plastic bags (usually polypropylene, sometimes polyolefin).
• Bag type: “single‑use, sterile, sealed plastic bag” with a 0.22 µm filter to prevent bacterial contamination. |
| Storage | • Keep refrigerated (2 – 8 °C).
• Do not freeze.
• Use within 24 h after opening; keep sealed otherwise. |
| Compatibility | • Polypropylene bags are generally considered chemically inert with respect to the glucose‑calcium solution.
• Avoid polycarbonate or PVC bags that may leach bisphenol‑A or phthalates—though most manufacturers use polypropylene to mitigate this.
• Ensure the bag material is compatible with the antiseptic (e.g., chlorhexidine) used for the exit‑site. |
| Safety Notes | • Check for any visible contamination or cloudiness before use.
• Inspect the bag for integrity (no punctures, leaks).
• Verify the calcium concentration on the label—some “low‑calcium” products come in 1.25 mmol/L or 1.5 mmol/L; ensure you use the intended dose. |
| Clinical Considerations | • Low‑calcium dialysate may help reduce systemic calcium overload, especially in patients with hyperparathyroidism or those on calcium‑based phosphate binders.
• The 1.5 % dextrose concentration provides a moderate dwell time glucose load; it's often paired with higher‑concentration solutions (2.5 % or 4.25 %) for longer dwell times if needed. |
| Regulatory Status | FDA‑approved (US) and EMA‑approved (EU) for peritoneal dialysis. |
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Why Plastic Bags are Preferred for Dianeal Low‑Calcium 1.5 % Dextrose
1. Sterility & Ease of Use – Plastic bags are single‑use, pre‑sterilized, and sealed, reducing contamination risk during handling.
2. Chemical Inertness – Polypropylene has low affinity for glucose, calcium, and electrolytes, minimizing leaching or absorption.
3. Cost‑Effectiveness & Convenience – Compared to pre‑filled syringes or vials, bags are economical for the large volumes used in dialysis.
4. Compatibility with Dialysis Pumps – Many CAPD and APD pumps are designed for bag delivery; the bag’s size fits the port and allows for easy tubing attachment.
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Practical Tips for Clinicians & Patients
| Situation | Action |
|-----------|--------|
| Bag Storage | Keep in a cool, dry place, ideally in a dedicated refrigerated compartment. |
| Bag Inspection | Look for bubbles, discoloration, or cracks. If any are present, discard the bag. |
| Mixing | Never mix Dianeal solutions of different glucose or calcium concentrations unless directed by a nephrologist. |
| Exit‑Site Care | Use chlorhexidine or other recommended antiseptic; ensure the bag material doesn’t react with the antiseptic. |
| Patient Education | Teach patients how to check the bag before each use and what signs indicate contamination (e.g., foul odor, cloudiness). |
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When to Use a Different Calcium Concentration
- High Calcium Requirement: If a patient has hypocalcemia or is on calcium‑based phosphate binders, a higher calcium dialysate (e.g., 1.75 mmol/L) might be indicated.
- Low Calcium Tolerance: For patients prone to cardiac arrhythmias or with low serum calcium, the low‑calcium 1.5 % solution is appropriate.
Always coordinate with the nephrology team to match the dialysate prescription to the patient’s serum electrolyte profile.
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Bottom Line
Yes, Dianeal Low‑Calcium with 1.5 % Dextrose is routinely available in sterile plastic bags that are chemically compatible and safe for peritoneal dialysis. Use the bags as directed, store properly, and inspect each bag before use. If you have specific concerns—such as potential plastic leaching, patient allergies, or storage logistics—discuss them with your pharmacy or dialysis coordinator.