Substitution of aluminium salts by magnesium salts in control of dialysis hyperphosphataemia.
For two years all 28 patients undergoing hospital haemodialysis were switched from a dialysate magnesium (Mg) of 0.85 mmol/l to one containing none. Oral aluminium hydroxide was discontinued, and magnesium carbonate was substituted as a phosphate binder. After 24 months on this regimen predialysis aluminium concentration had fallen significantly. There was no significant change in predialysis phosphate, which remained above the normal range; nor was there evidence of increased secondary hyperparathyroidism as judged by parathyroid hormone immunoassay and biochemical or clinical criteria. Predialysis Mg concentrations tended to fall towards the normal range. Aluminium-containing phosphate binders seem to be unnecessary for the control of dialysis hyperphosphataemia. Magnesium carbonate may be an alternative and less toxic compound.
O'Donovan
R
R
Baldwin
D
D
Hammer
M
M
Moniz
C
C
Parsons
V
V
D000284:Administration, Oral; D000469:Alkaline Phosphatase / Q000097:blood; D000535:Aluminum / Q000097:blood; D000536:Aluminum Hydroxide / Q000009:adverse effects*; D002118:Calcium / Q000097:blood; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use; D008274:Magnesium / Q000008:administration & dosage*; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors
D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; D010710:Phosphates; C005479:magnesium carbonate; D000536:Aluminum Hydroxide; D000535:Aluminum; D000469:Alkaline Phosphatase; D008274:Magnesium; D002118:Calcium; C008088:alfacalcidol