[Replacement of aluminum-containing phosphate binders by calcium and magnesium carbonates in long-term hemodialysis].
Aluminium-containing phosphate binders were replaced by a calcium and magnesium carbonate-containing antacid in 20 patients on long-term haemodialysis, over a three-month period in all of them, for 12 months in ten. After two months the serum aluminium level fell (mean +/- SD) from 3.0 +/- 1.6 to 1.4 +/- 0.5 mumol/l (P less than 0.001). After three months the serum phosphate level had fallen from 1.8 +/- 0.4 to 1.5 +/- 0.4 mumol/l (P less than 0.05), while during the same period parathormone (PTH-NH2) fell from 1.4 +/- 1.4 to 0.8 +/- 0.7 ng/ml (P less than 0.05). Serum total calcium concentration rose after two months from 2.2 +/- 0.2 to 2.4 +/- 0.2 mmol/l (P less than 0.001). In a third of patients the uraemic acidosis was corrected, standard bicarbonate rising from 18 +/- 2 to 21 +/- 3 mmol/l (P less than 0.05). Serum pH, potassium, sodium, magnesium and alkaline phosphatase did not change significantly. Hypercalcaemia was an expected disadvantage: repeated symptom-free episodes of hypercalcaemia occurred in six of 20 patients during the first three months and in a further two up to 12 months. These episodes were successfully controlled by a reduction of CaCO3/MgCO3 dosage and readministration of Al(OH)3. Extraosseous calcifications were not observed.
Zellweger
U
U
Kantonsspital Winterthur, Orthopädische Universitätsklinik Balgrist, Zürich.
Zaugg
P Y
PY
Dambacher
M
M
Binswanger
U
U
Gautschi
K
K
Hany
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000535:Aluminum / Q000097:blood*; D000863:Antacids; D001639:Bicarbonates / Q000097:blood; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate; D005260:Female; D006801:Humans; D008274:Magnesium; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis; D013997:Time Factors
D000863:Antacids; D001639:Bicarbonates; D010281:Parathyroid Hormone; D010710:Phosphates; C005479:magnesium carbonate; D000535:Aluminum; D002119:Calcium Carbonate; D008274:Magnesium; D002118:Calcium
Ersatz aluminiumhaltiger Phosphatbinder bei Langzeit-Hämodialyse-Patienten durch Calcium- und Magnesiumcarbonat.