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Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia

BACKGROUND: Calcium-based and non-calcium-based phosphate binders have similar efficacy in the treatment of hyperphosphatemia; however, calcium-based binders may be associated with hypercalcemia, vascular calcification, and adynamic bone disease. SCOPE: A post hoc analysis was carried out of data fr...

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Autores principales: Wilson, Rosamund J, Copley, J Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Just Medical Media Limited 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5279921/
https://www.ncbi.nlm.nih.gov/pubmed/28182142
http://dx.doi.org/10.7573/dic.212302
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author Wilson, Rosamund J
Copley, J Brian
author_facet Wilson, Rosamund J
Copley, J Brian
author_sort Wilson, Rosamund J
collection PubMed
description BACKGROUND: Calcium-based and non-calcium-based phosphate binders have similar efficacy in the treatment of hyperphosphatemia; however, calcium-based binders may be associated with hypercalcemia, vascular calcification, and adynamic bone disease. SCOPE: A post hoc analysis was carried out of data from a 16-week, Phase IV study of patients with end-stage renal disease (ESRD) who switched to lanthanum carbonate monotherapy from baseline calcium acetate/calcium carbonate monotherapy. Of the intent-to-treat population (N=2520), 752 patients with recorded dose data for calcium acetate (n=551)/calcium carbonate (n=201) at baseline and lanthanum carbonate at week 16 were studied. Elemental calcium intake, serum phosphate, corrected serum calcium, and serum intact parathyroid hormone levels were analyzed. FINDINGS: Of the 551 patients with calcium acetate dose data, 271 (49.2%) had an elemental calcium intake of at least 1.5 g/day at baseline, and 142 (25.8%) had an intake of at least 2.0 g/day. Mean (95% confidence interval [CI]) serum phosphate levels were 6.1 (5.89, 6.21) mg/dL at baseline and 6.2 (6.04, 6.38) mg/dL at 16 weeks; mean (95% CI) corrected serum calcium levels were 9.3 (9.16, 9.44) mg/dL and 9.2 (9.06, 9.34) mg/dL, respectively. Of the 201 patients with calcium carbonate dose data, 117 (58.2%) had an elemental calcium intake of at least 1.5 g/day, and 76 (37.8%) had an intake of at least 2.0 g/day. Mean (95% CI) serum phosphate levels were 5.8 (5.52, 6.06) mg/dL at baseline and 5.8 (5.53, 6.05) mg/dL at week 16; mean (95% CI) corrected serum calcium levels were 9.7 (9.15, 10.25) mg/dL and 9.2 (9.06, 9.34) mg/dL, respectively. CONCLUSION: Calcium acetate/calcium carbonate phosphate binders, taken to control serum phosphate levels, may result in high levels of elemental calcium intake. This may lead to complications related to calcium balance.
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spelling pubmed-52799212017-02-08 Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia Wilson, Rosamund J Copley, J Brian Drugs Context Original Research BACKGROUND: Calcium-based and non-calcium-based phosphate binders have similar efficacy in the treatment of hyperphosphatemia; however, calcium-based binders may be associated with hypercalcemia, vascular calcification, and adynamic bone disease. SCOPE: A post hoc analysis was carried out of data from a 16-week, Phase IV study of patients with end-stage renal disease (ESRD) who switched to lanthanum carbonate monotherapy from baseline calcium acetate/calcium carbonate monotherapy. Of the intent-to-treat population (N=2520), 752 patients with recorded dose data for calcium acetate (n=551)/calcium carbonate (n=201) at baseline and lanthanum carbonate at week 16 were studied. Elemental calcium intake, serum phosphate, corrected serum calcium, and serum intact parathyroid hormone levels were analyzed. FINDINGS: Of the 551 patients with calcium acetate dose data, 271 (49.2%) had an elemental calcium intake of at least 1.5 g/day at baseline, and 142 (25.8%) had an intake of at least 2.0 g/day. Mean (95% confidence interval [CI]) serum phosphate levels were 6.1 (5.89, 6.21) mg/dL at baseline and 6.2 (6.04, 6.38) mg/dL at 16 weeks; mean (95% CI) corrected serum calcium levels were 9.3 (9.16, 9.44) mg/dL and 9.2 (9.06, 9.34) mg/dL, respectively. Of the 201 patients with calcium carbonate dose data, 117 (58.2%) had an elemental calcium intake of at least 1.5 g/day, and 76 (37.8%) had an intake of at least 2.0 g/day. Mean (95% CI) serum phosphate levels were 5.8 (5.52, 6.06) mg/dL at baseline and 5.8 (5.53, 6.05) mg/dL at week 16; mean (95% CI) corrected serum calcium levels were 9.7 (9.15, 10.25) mg/dL and 9.2 (9.06, 9.34) mg/dL, respectively. CONCLUSION: Calcium acetate/calcium carbonate phosphate binders, taken to control serum phosphate levels, may result in high levels of elemental calcium intake. This may lead to complications related to calcium balance. Just Medical Media Limited 2017-01-20 /pmc/articles/PMC5279921/ /pubmed/28182142 http://dx.doi.org/10.7573/dic.212302 Text en Copyright © 2017 Wilson RJ, Copley JB Distributed under the terms of the Creative Commons License Deed CC BY NC ND 3.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.
spellingShingle Original Research
Wilson, Rosamund J
Copley, J Brian
Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia
title Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia
title_full Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia
title_fullStr Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia
title_full_unstemmed Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia
title_short Elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia
title_sort elemental calcium intake associated with calcium acetate/calcium carbonate in the treatment of hyperphosphatemia
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5279921/
https://www.ncbi.nlm.nih.gov/pubmed/28182142
http://dx.doi.org/10.7573/dic.212302
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