Comparison between the use of tablets of carbonate or calcium acetate, with calcium carbonate in emulsion, in a population of patients with chronic renal disease

Hyperphosphatemia in chronic kidney disease (CKD) is associated with severe complications and increased morbidity and mortality. 95% of dialysis patients must use phosphate binders to its control. The poor tolerance and complications of these treatments, make difficult its compliance and effectiveness. This study compares the use of carbonate and / or calcium acetate tablets with an emulsion of calcium carbonate (CaCO3) for the management of this hyperphosphatemia. In 98 patients, the tablets (1250 mg CaCO3 E 500 mg elemental calcium or 1000 mg calcium acetate E 250 mg elemental calcium), were replaced for CaCO3 emulsion (1 dose = 1 tablespoon equivalent to 500 mg elemental calcium). At baseline and after three months, laboratory assessments and a satisfaction survey were performed. The daily dose of chelating agents was similar (4.5 +/- 3.7 tablets; 4.2 +/- 2.7 tablespoons of emulsion); phosphatemia and calcium-phosphorus product were significantly lower during the period with emulsion (5.8 +/- 1.6 mg / dl and 51.9 +/- 15.6 with tablets, 5.5 +/- 1.5 mg / dl and 49.6 +/- 15.0 with emulsion, p = 0.003); calcemia was not significant different. 79% of patients preferred the emulsion. 39.8% of patients admitted failing to comply with treatment with tablets; the dropout rate with the emulsion was 18%. Thus, to chelate phosphorus, CaCO3 emulsion was at least as effective as tablets; its better tolerance and acceptability make this formulation, an advantageous therapeutic option to consider.