Phosphate-binding capacity of ferrihydrite versus calcium acetate in rats.

Calcium salts, such as calcium carbonate and calcium acetate, are the principal compounds used as phosphate binders in patients with chronic renal failure. The dose required is three to six times the normal requirement for calcium. Use of these large doses of calcium salts in the diet can result in hypercalcemia. Other compounds have been investigated as phosphate binders with varying degrees of success. Synthetic ferrihydrite (5Fe(2)O(3).9H(2)O) has a high adsorptive capacity for phosphate and may be an effective phosphate binder. The phosphate-binding capacity of ferrihydrite was compared with that of calcium acetate in 250-g male Sprague Dawley rats. After an overnight fast, rats (n = 5 per group) were gavaged with an American Institute of Nutrition (AIN) 76 formula containing one third the daily phosphorus intake labeled with phosphorus-32 ((32)P). Either two levels of calcium acetate, representing three (1/2X) or six (1X) times the usual calcium intake for one third of the day, or equivalent amounts of ferrihydrite were added to the diet. An additional group received two times (2X) the larger dose, and a sixth control group received no binder in the diet. Phosphorus absorption curves were determined from (32)P appearance in the serum. The 1/2X dose of ferrihydrite reduced (32)P by approximately one half, and the 2X dose nearly completely suppressed (32)P absorption, similar to the 1X dose of calcium acetate. The advantage of using a ferrihydrite binder would be to avoid the hypercalcemia resulting from the use of high-dose calcium salts. An added advantage may result from the small amounts of iron absorbed in these chronically iron-deficient patients.

Effect of sorbitol on the phosphate adsorptive capacity of ferrihydrite suspensions.

The purpose of this study was to stabilize the phosphate adsorptive capacity of aqueous suspensions of ferrihydrite, a potential phosphate binder. Ferrihydrite was precipitated by the addition of 1 N NaOH to 1 M FeCl3 until pH 8.0 was reached. The ferrihydrite suspension was divided into three portions and an amount of sorbitol was added to produce sorbitol concentrations of 0, 1, or 5% w/v, respectively. The phosphate adsorptive capacity and X-ray diffraction pattern were periodically determined during aging at room temperature. The phosphate adsorptive capacity of the ferrihydrite suspension containing 0% sorbitol decreased steadily from 0.012 mgP/mg to 0.007 mgP/mg during the 1-year aging period. In contrast, suspensions containing 1 or 5% sorbitol exhibited constant phosphate adsorptive capacities during this period. X-ray diffraction patterns revealed that ferrihydrite transformed to hematite and goethite during aging of the control suspension. The presence of 1 or 5% sorbitol prevented the transformation of ferrihydrite to more crystalline iron oxides. This study suggests that the phosphate adsorptive capacity of ferrihydrite suspensions can be stabilized by the incorporation of small amounts of sorbitol into the formulation.