A previous short-term study of 10 weeks in 8 patients had shown us that with half the dose of elemental
calcium,
calcium acetate (
CaAc) could control predialysis plasma
phosphate (PPO4) as well as
calcium carbonate (CaCO3) but that the incidence of
hypercalcemia was not decreased. To better appreciate the value of
CaAc in comparison to CaCO3,
CaAc was given to 28 patients on chronic
hemodialysis (6 men, 22 women, age 61 +/- 14 years;
dialyzate Ca:1.5 mmol/l) for 6 months to replace CaCO3 at half the dose of elemental
calcium (1,235 +/- 521 versus 2,375 +/- 1,470 mg/day). Because of gastrointestinal intolerance,
CaAc had to be discontinued in 5 patients after 1-5 months.
Magnesium hydroxide [Mg(OH)2] given in 18 of them in association with CaCO3 was discontinued and reintroduced in 6 patients in order to keep PPO4 < 2 mmol/l. Mean dosage of Mg(
OH)2 was 2.09 +/- 1.4 g/day with CaCO3 and 0.9 +/- 0.5 with
CaAc. Predialysis plasma concentrations of
calcium and
phosphate were monitored weekly during the 3 months of the control period under CaCO3 and during the 6-month administration of
CaAc. Plasma
calcium (PCa) was comparable with the 2 treatments (2.47 +/- 0.11 vs. 2.5 +/- 0.10 mmol/l), but PPO4 was significantly lower with
CaAc (1.82 +/- 0.26 vs. 1.73 +/- 0.23 mmol/l). Plasma
alkaline phosphatase remained constant (122 +/- 66 vs. 122 +/- 70; normal < 170 UI/l) as well as plasma intact PTH (121 +/- 153 vs. 121 +/- 146; normal < 54 pg/ml) and plasma
aluminum (0.34 +/- 0.23 vs. 0.32 +/- 0.20 mumol/l).(ABSTRACT TRUNCATED AT 250 WORDS)