Abstract | BACKGROUND: We recently determined that in hemodialysis patients, the use of calcium salts to correct hyperphosphatemia led to progressive coronary artery and aortic calcification as determined by sequential electron beam tomography (EBT) while the use of the non- calcium-containing binder sevelamer did not. Whether the specific calcium preparation ( acetate vs. carbonate) might influence the likelihood of progressive calcification was debated. METHODS: RESULTS: The reduction in serum phosphorus was roughly equivalent with both agents ( calcium acetate -2.5 +/- 1.8 mg/dl vs. sevelamer -2.8 +/- 2.0 mg/dl, p = 0.53). Subjects given calcium acetate were more likely to develop hypercalcemia (defined as an albumin-corrected serum calcium > or =10.5 mg/dl) (36 vs. 13%, p = 0.015). Treatment with calcium acetate (mean 4.6 +/- 2.1 g/day - equivalent to 1.2 +/- 0.5 g of elemental calcium) led to a significant increase in EBT-determined calcification of the coronary arteries (mean change 182 +/- 350, median change +20, p = 0.002) and aorta (mean change 181 +/- 855, median change +73, p < 0.0001). These changes were similar in magnitude to those seen with calcium carbonate. There were no significant changes in calcification among sevelamer-treated subjects. CONCLUSION:
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Authors | Glenn M Chertow, Paolo Raggi, James T McCarthy, Gerald Schulman, Jeffrey Silberzweig, Amy Kuhlik, William G Goodman, Amy Boulay, Steven K Burke, Robert D Toto |
Journal | American journal of nephrology
(Am J Nephrol)
2003 Sep-Oct
Vol. 23
Issue 5
Pg. 307-14
ISSN: 0250-8095 [Print] Switzerland |
PMID | 12915774
(Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)
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Copyright | Copyright 2003 S. Karger AG, Basel |
Chemical References |
- Acetates
- Calcium Compounds
- Epoxy Compounds
- Phosphates
- Polyamines
- Polyethylenes
- Sevelamer
- Calcium
- calcium acetate
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Topics |
- Acetates
(adverse effects, pharmacology)
- Adult
- Aortic Diseases
(chemically induced)
- Arteriosclerosis
(chemically induced)
- Calcinosis
(prevention & control)
- Calcium
(blood)
- Calcium Compounds
- Epoxy Compounds
(adverse effects, pharmacology)
- Female
- Humans
- Hypercalcemia
(chemically induced)
- Male
- Middle Aged
- Phosphates
(blood)
- Polyamines
- Polyethylenes
(adverse effects, pharmacology)
- Renal Dialysis
(adverse effects)
- Sevelamer
- Statistics, Nonparametric
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