Dianeal low calcium w/ dextrose 2.5% in plastic container?

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Dianeal® Low‑Calcium, 2.5 % Dextrose – Plastic Container (Fresenius Kabi, Inc.)

Item	Details
Name	Dianeal Low‑Calcium 2.5 % Dextrose
Manufacturer	Fresenius Kabi
Indication	Exchange solution for continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD) in patients with end‑stage renal disease (ESRD).
Form	2.5 % dextrose solution, low‑calcium concentration (≈ 1.25 mEq L⁻¹).
Container	Single‑use, polypropylene (PP) plastic bag (typically 1 L, 1.5 L, 2 L, 3 L).
Sterility	Sterile, pyrogen‑free; not suitable for IV use.

Component	Concentration	Units	Notes
Dextrose	2.5 %	w/v	~ 111 mmol L⁻¹ (≈ 470 mOsm kg⁻¹)
Sodium (Na⁺)	140	mEq L⁻¹	Maintains isotonicity
Potassium (K⁺)	2.5	mEq L⁻¹	Low K to reduce hyperkalemia risk
Calcium (Ca²⁺)	1.25	mEq L⁻¹	“Low‑Calcium” vs. “Normal” (≈ 1.75 mEq L⁻¹)
Magnesium (Mg²⁺)	0.5	mEq L⁻¹	Low Mg to prevent hypermagnesemia
Total Osmolality	~ 470 mOsm kg⁻¹		Slightly hypertonic relative to plasma (285 mOsm)

Important: Exact values may vary slightly by batch; always refer to the current prescribing information for the product you have.

Parameter	Typical Recommendation	Notes
Volume per Dwell	1–1.5 L per exchange	Depends on patient’s peritoneal cavity size and transport characteristics
Dwell Time	4–6 h (CAPD)	APD dwell times are set by machine; usually 4 h dwell, 6 h cycle
Frequency	4 exchanges/day (CAPD)	APD: 3–4 exchanges per night
Indication	Low‑calcium 2.5 % is used when the patient needs a lower serum calcium target or when a higher calcium load would worsen vascular calcification, bone disease, or hyperparathyroidism.	Use only as directed by nephrologist

Item	Recommendation
Pre‑Use	Inspect bag for intact seal, absence of bubbles or discoloration. Verify expiration date.
Temperature	Store at 15–30 °C (room temperature). Protect from direct light.
After Opening	Keep the bag in a PD unit at 15–30 °C. Do not refrigerate.
Disposal	Use a closed‑containment system to dispose of empty bags. Do not reuse.
Compatibility	Compatible with standard peritoneal dialysis catheters, adapters, and APD machines. Not compatible with intravenous tubing or pumps.
Plastic Considerations	The polypropylene bag is specifically formulated to resist leaching of plasticizers (e.g., DEHP). However, if a patient has known sensitivity to plastic additives, use a certified “DEHP‑free” bag if available.

Category	Key Points
Electrolyte Imbalance	- Hypocalcemia risk if serum calcium is already low. - Hypomagnesemia may occur with long‑term use; monitor magnesium. - Hyperkalemia risk is lower due to 2.5 mEq L⁻¹ K⁺.
Volume Status	Dextrose provides osmotic diuresis; can affect fluid balance. Monitor weight and BP.
Glucose Tolerance	2.5 % dextrose may influence glucose control in diabetic patients.
Peritoneal Membrane	Long‑term high‑glucose solutions can accelerate membrane thickening. Low‑calcium solutions are often paired with low‑glucose dwell for patients needing low‑calcium.
Drug Interactions	- Calcium supplements, antacids, vitamin D analogues, or calcimimetics may further lower serum calcium. - Diuretics (especially loop diuretics) may exacerbate hypomagnesemia.
Contraindications	- Known allergy to any component (e.g., dextrose, sodium). - Severe hypermagnesemia.
Adverse Reactions	Abdominal cramping, nausea, hypotension (rare), periton

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