Treatment of uraemic hyperphosphatemia with calcium acetate: a safe alternative to calcium carbonate.
Clinical usefulness of calcium acetate (CAA) as phosphorus binder was assessed in 19 stable hemodialysis patients with persistent hyperphosphatemia. All were dialysed thrice weekly with a constant dialytic schedule and a dialysate calcium of 3.5 mEq/l. One month prior the study beginning all patients stopped assumption of Ca and vitamin D supplements. In the first period of the study CAA (mean daily doses 2.2 g) was administered for one month followed by 15 days of withdrawal. The mean serum phosphorus decreased from 7.6 +/- 1.4 to 5.8 +/- 0.8 mg% (p < 0.005). After 15 days of withdrawal mean serum phosphorus reached the pretreatment value. Then the patients entered a long term study with personalized doses of CAA (between 1 and 4 g/day) and administration in 8 of them of alpha-calcidol. After a mean follow-up period of 5.4 +/- 1.5 months serum phosphorus was reduced from 7.5 +/- 1.1 to 5.6 +/- 1.1 mg% (p < 0.0005) while calcemia increased from 9.0 +/- 0.7 to 9.6 +/- 0.6 mg% (p < 0.005). Only one patient developed mild hypercalcemia. We concluded that CAA is a safe alternative to calcium carbonate for the control of hyperphosphatemia of uraemic patients for the most efficient phosphorus binding and the lesser absorption of calcium.
Biagini
M
M
Nephrology and Dialysis Unit-USL, Civitavecchia, Italy.
Malaguti
M
M
Sicoli
R
R
Capece
R
R
Friggi
A
A
Ciaffi
G
G
Bargagna
R
R
D000085:Acetates / Q000737:chemistry / Q000627:therapeutic use*; D019342:Acetic Acid; D000328:Adult; D000368:Aged; D002119:Calcium Carbonate; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood* / Q000737:chemistry; D006435:Renal Dialysis; D014511:Uremia / Q000097:blood / Q000188:drug therapy*
D000085:Acetates; D010710:Phosphates; D002119:Calcium Carbonate; D019342:Acetic Acid