Calcium carbonate (CaCO3): an efficient and safe phosphate binder in haemodialysis patients? A 3-year study.

In an uncontrolled study, 22 dialysis patients (46 +/- 14 years, duration of dialysis 20 +/- 11 months) were treated with CaCO3 over a period of up to 3 years to lower their serum phosphate. The use of 4.5-9 g CaCO3 daily over a period of 9 months led to a reduction of mean serum phosphate from 2.51 to 1.51 mmol/l in 77% of patients, with a simultaneous increase in mean calcium concentration from 2.23 to 2.47 mmol/l, and an improved control of secondary hyperparathyroidism by reduction in mPTH from 1552 to 1032 pg/ml and in APH activity from 6.25 to 4.55 mumol/s/l. In long-term CaCO3 treatment of up to 3 years, however, a constant effective phosphate reduction could not be achieved. There was a progression (77%) of pre-existing microcalcification and a new appearance (42%) of microcalcification in vessels and soft-tissue areas of the hand. The percentage of patients with soft-tissue calcification increased from 43 to 67% during a treatment period of 3 years. We conclude that CaCO3 alone is not suitable on a long-term basis for phosphate reduction in dialysis patients.
AuthorsH Sperschneider, K Günther, I Marzoll, E Kirchner, G Stein
JournalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 8 Issue 6 Pg. 530-4 ( 1993) ISSN: 0931-0509 [Print] ENGLAND
PMID8394534 (Publication Type: Journal Article)
Chemical References
  • Phosphates
  • Calcium Carbonate
  • Adult
  • Calcinosis (etiology)
  • Calcium Carbonate (adverse effects, metabolism)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phosphates (metabolism)
  • Renal Dialysis

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