Differences in gastrointestinal calcium absorption after the ingestion of calcium-free phosphate binders

被引:17
作者
Behets, Geert J. [1 ]
Dams, Geert [1 ]
Damment, Stephen J. [2 ]
Martin, Patrick [3 ]
De Broe, Marc E. [1 ]
D'Haese, Patrick C. [1 ]
机构
[1] Univ Antwerp, Lab Pathophysiol, B-2610 Antwerp, Belgium
[2] Shire, Basingstoke, Hants, England
[3] Shire, Wayne, PA USA
关键词
calcium; phosphate binders; gastrointestinal absorption; LANTHANUM CARBONATE; SERUM PHOSPHORUS; BONE; CA2+;
D O I
10.1152/ajprenal.00219.2013
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Both calcium-containing and noncalcium-containing phosphate binders can increase gastrointestinal calcium absorption. Previously, we observed that lanthanum carbonate administration to rats with renal failure is not associated with increased calciuria. Additionally, lanthanum carbonate treatment in dialysis patients has been associated with a less pronounced initial decrease in serum parathyroid hormone compared with other phosphate binders. For 8 days, male Wistar rats received a diet supplemented with 2% lanthanum carbonate, 2% sevelamer, 2% calcium carbonate, or 2% cellulose. Calciuria was found to be increased in animals with normal renal function treated with sevelamer or calcium carbonate but not with lanthanum carbonate. In animals with renal failure, cumulative calcium excretion showed similar results. In rats with normal renal function, serum ionized calcium levels were increased after 2 days of treatment with sevelamer, while calcium carbonate showed a smaller increase. Lanthanum carbonate did not induce differences. In animals with renal failure, no differences were found between sevelamer-treated, calcium carbonate-treated, and control groups. Lanthanum carbonate, however, induced lower ionized calcium levels within 2 days of treatment. These results were confirmed in normal human volunteers, who showed lower net calcium absorption after a single dose of lanthanum carbonate compared with sevelamer carbonate. In conclusion, these two noncalcium-containing phosphate-binding agents showed a differential effect on gastrointestinal calcium absorption. These findings may help to improve the management of calcium balance in patients with renal failure, including concomitant use of vitamin D.
引用
收藏
页码:F61 / F67
页数:7
相关论文
共 25 条
[1]   Effects of efficient phosphate binding on bone in chronic renal failure rats [J].
Behets, GJ ;
Gritters, M ;
Dams, G ;
De Broe, ME ;
D'Haese, PC .
RENAL FAILURE, 2005, 27 (04) :475-484
[2]   Lanthanum carbonate: a new phosphate binder [J].
Behets, GJ ;
Verberckmoes, SC ;
D'Haese, PC ;
De Broe, ME .
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION, 2004, 13 (04) :403-409
[4]   A multicenter study on the effects of lanthanum carbonate (Fosrenol™) and calcium carbonate on renal bone disease in dialysis patients [J].
D'Haese, PC ;
Spasovski, GB ;
Sikole, A ;
Hutchison, A ;
Freemont, TJ ;
Sulkova, S ;
Swanepoel, C ;
Pejanovic, S ;
Djukanovic, L ;
Balducci, A ;
Coen, G ;
Sulowicz, W ;
Ferreira, A ;
Torres, A ;
Curic, S ;
Popovic, M ;
Dimkovic, N ;
De Broe, ME .
KIDNEY INTERNATIONAL, 2003, 63 :S73-S78
[5]  
Damment SJP, 2005, CLIN NEPHROL, V63, P127
[6]   Effects of sevelamer hydrochloride and calcium carbonate on renal osteodystrophy in hemodialysis patients [J].
Ferreira, Anibal ;
Frazo, Joao Miguel ;
Monier-Faugere, Marie-Claude ;
Gil, Celia ;
Galvao, Jose ;
Oliveira, Carlos ;
Baldaia, Jorge ;
Rodrigues, Ilidio ;
Santos, Carla ;
Ribeiro, Silvia ;
Hoenger, Regula Mueller ;
Duggal, Ajay ;
Malluche, Hartmut H. .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2008, 19 (02) :405-412
[7]  
Finn WF, 2006, CLIN NEPHROL, V65, P191
[8]  
Foley RN, 1998, J AM SOC NEPHROL, V9, P267
[9]   The Functions and Roles of the Extracellular Ca2+-Sensing Receptor along the Gastrointestinal Tract [J].
Geibel, John P. ;
Hebert, Steven C. .
ANNUAL REVIEW OF PHYSIOLOGY, 2009, 71 :205-217
[10]   Calcium absorption across epithelia [J].
Hoenderop, JGJ ;
Nilius, B ;
Bindels, RJM .
PHYSIOLOGICAL REVIEWS, 2005, 85 (01) :373-422