CALCIUM-CARBONATE (CACO3) - AN EFFICIENT AND SAFE PHOSPHATE BINDER IN HEMODIALYSIS-PATIENTS - A 3-YEAR STUDY

被引:54
作者
SPERSCHNEIDER, H [1 ]
GUNTHER, K [1 ]
MARZOLL, I [1 ]
KIRCHNER, E [1 ]
STEIN, G [1 ]
机构
[1] FRIEDRICH SCHILLER UNIV,DEPT INTERNAL MED,O-6900 JENA,GERMANY
关键词
HEMODIALYSIS PATIENTS; CALCIUM CARBONATE (CACO3); LONG-TERM EFFECT; METASTATIC CALCIFICATION;
D O I
10.1093/ndt/8.6.530
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
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.
引用
收藏
页码:530 / 534
页数:5
相关论文
共 23 条
[1]  
ALMIRAL J, 1987, LANCET, V3, P799
[2]   CALCIUM-CARBONATE IS AN EFFECTIVE PHOSPHORUS BINDER IN CHILDREN WITH CHRONIC-RENAL-FAILURE [J].
ANDREOLI, SP ;
DUNSON, JW ;
BERGSTEIN, JM .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1987, 9 (03) :206-210
[3]  
BRAHM M, 1986, CLIN NEPHROL, V25, P231
[4]  
BURKART J, 1988, 18TH ANN SCI M NAT K
[5]   THE APPROACH TO THE TREATMENT OF SECONDARY HYPERPARATHYROIDISM IN EARLY RENAL-FAILURE [J].
FOURNIER, A ;
MORINIERE, P ;
RENAUD, H .
AMERICAN JOURNAL OF NEPHROLOGY, 1988, 8 (02) :170-172
[6]  
GRABEN M, 1988, NIEREN UND HOCHDRUCK, V17, P52
[7]  
HERCZ G, 1986, MINER ELECTROL METAB, V12, P314
[8]   COMPARISON OF CALCIUM-CARBONATE AND ALUMINUM HYDROXIDE AS PHOSPHATE BINDERS ON BIOCHEMICAL BONE MARKERS, PTH(1-84), AND BONE-MINERAL CONTENT IN DIALYSIS PATIENTS [J].
JESPERSEN, B ;
JENSEN, JD ;
NIELSEN, HK ;
LAURIDSEN, IN ;
ANDERSEN, MJF ;
POULSEN, JH ;
GAMMELGAARD, B ;
PEDERSEN, EB .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 1991, 6 (02) :98-104
[9]  
MACTIER RA, 1987, CLIN NEPHROL, V5, P222
[10]  
MALBERTI F, 1988, KIDNEY INT S24, V33, P184