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Calcium acetate versus calcium carbonate in the control of hyperphosphatemia in hemodialysis patients
D'Almeida Filho, Eufrônio José; Cruz, Elisa De Albuquerque Sampaio Da; Hoette, Marcos; Ruzany, Frederico; Keen, Luana Neves Lopes; Lugon, Jocemir Ronaldo.
  • D'Almeida Filho, Eufrônio José; Francisco Santino Filho Kidney Foundation. Rio de Janeiro. BR
  • Cruz, Elisa De Albuquerque Sampaio Da; Universidade Federal Fluminense. Niterói. BR
  • Hoette, Marcos; Francisco Santino Filho Kidney Foundation. Rio de Janeiro. BR
  • Ruzany, Frederico; Francisco Santino Filho Kidney Foundation. Rio de Janeiro. BR
  • Keen, Luana Neves Lopes; Universidade Federal Fluminense. Niterói. BR
  • Lugon, Jocemir Ronaldo; Universidade Federal Fluminense. Niterói. BR
São Paulo med. j ; 118(6): 179-84, Nov. 2000. graf, tab
Artigo em Inglês | LILACS | ID: lil-277626
ABSTRACT
CONTEXT Hyperphosphatemia has an important role in the development of bone and mineral abnormalities in end-stage renal disease (ESRD).

OBJECTIVE:

To compare the phosphorus binding power and the hypercalcemic effect of calcium acetate and calcium carbonate in hemodialysis patients. TYPE OF STUDY Crossover, randomized, double-blind study. PLACE A private hospital dialysis center.

PARTICIPANTS:

Fifty-two patients who were undergoing regular hemodialysis three times a week ([Ca++] dialysate = 3.5 mEq/L). PROCEDURES Half of the patients were started on 5.6 g/day of calcium acetate and, after a 2 week washout period, received 6.2 g/day of calcium carbonate. The other half followed an inverse protocol. MAIN MEASUREMENTS Clinical interviews were conducted 3 times a week to monitor for side effects. Determinations of serum urea, calcium, phosphorus, hematocrit, Kt/V and blood gas analysis were obtained before and after each treatment.

RESULTS:

Twenty-three patients completed the study. A significant increase in calcium plasma levels was only observed after treatment with calcium carbonate [9.34 mg/dl (SD 0.91) vs. 9.91 mg/dl (SD 0.79), P < 0.01]. The drop in phosphorus levels was substantial and significant for both salts [5.64 mg/dl (SD 1.54) vs. 4.60 mg/dl (SD 1.32), P < 0.01 and 5.89 mg/dl (SD 1.71) vs. 4.56 mg/dl (SD 1.57), P < 0.01, for calcium acetate and calcium carbonate respectively]. The percentage reduction in serum phosphorus (at the end of the study) per milliequivalent of salt administered per day tended to be higher with calcium acetate but statistical significance was not found.

CONCLUSION:

Calcium acetate can be a good alternative to calcium carbonate in the handling of hyperphosphatemia in ESRD patients. When calcium acetate is used, control of hyperphosphatemia can be achieved with a lower administration of calcium, perhaps with a lower risk of hypercalcemia
Assuntos
Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Fósforo / Carbonato de Cálcio / Diálise Renal / Falência Renal Crônica / Antiácidos / Acetatos Tipo de estudo: Ensaio Clínico Controlado / Guia de Prática Clínica Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: São Paulo med. j Assunto da revista: Cirurgia Geral / Ciˆncia / Ginecologia / Medicina / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Ano de publicação: 2000 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Francisco Santino Filho Kidney Foundation/BR / Universidade Federal Fluminense/BR

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Fósforo / Carbonato de Cálcio / Diálise Renal / Falência Renal Crônica / Antiácidos / Acetatos Tipo de estudo: Ensaio Clínico Controlado / Guia de Prática Clínica Limite: Adulto / Feminino / Humanos / Masculino Idioma: Inglês Revista: São Paulo med. j Assunto da revista: Cirurgia Geral / Ciˆncia / Ginecologia / Medicina / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Ano de publicação: 2000 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Francisco Santino Filho Kidney Foundation/BR / Universidade Federal Fluminense/BR