Magnesium carbonate is an effective phosphate binder for chronic hemodialysis patients: a pilot study.
OBJECTIVE
This study was designed to evaluate the efficacy of magnesium carbonate as a phosphate binder in hemodialysis patients.


METHODS
This study was a prospective, randomized, open-label trial comparing magnesium carbonate/calcium carbonate versus calcium acetate as a sole phosphate binder.


METHODS
This study involved outpatient hemodialysis.


METHODS
We recruited 30 stable hemodialysis patients without a history of frequent diarrhea.


METHODS
After receiving informed consent, we randomized patients 2:1 to magnesium carbonate versus calcium acetate. The dose of each binder was titrated to achieve the Kidney Disease Outcomes Quality Initiative (K/DOQI) phosphate target of <5.5 mg/dL.


METHODS
The efficacy-phase serum phosphorus concentration and the percentage of patients meeting K-DOQI targets for phosphorus, along with the daily elemental calcium intake, were the primary outcome measures.


RESULTS
Magnesium carbonate provided equal control of serum phosphorus (70.6% of the magnebind group and 62.5% of the calcium acetate group had their average serum phosphorus within the K-DOQI target during the efficacy phase), while significantly reducing daily elemental calcium ingestion from phosphate binders (908 +/- 24 vs. 1743 +/- 37 mg/day, P < .0001).


CONCLUSIONS
Magnesium carbonate was generally well-tolerated in this selected patient population, and was effective in controlling serum phosphorus while reducing elemental calcium ingestion.
Spiegel
David M
DM
University of Colorado Health Sciences Center, Denver, Colorado, USA. david.spiegel@uchsc.edu
Farmer
Beverly
B
Smits
Gerard
G
Chonchol
Michel
M
D002136:Calcium, Dietary / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008274:Magnesium / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000378:metabolism*; D010758:Phosphorus / Q000097:blood*; D010760:Phosphorus Metabolism Disorders / Q000188:drug therapy*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D016896:Treatment Outcome
D002136:Calcium, Dietary; D010710:Phosphates; C005479:magnesium carbonate; D010758:Phosphorus; D008274:Magnesium