Calcium load during administration of calcium carbonate or sevelamer in individuals with normal renal function

Heinrich, T.; Heidt, Hartmut; Hafner, Verena; Schmidt‐Gayk, H.; Jenetzky, Ekkehart; Walter‐Sack, Ingeborg; Mikus, Gerd; Bommer, J

doi:10.1093/ndt/gfn151

Cited by 16 publications

(14 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dosing with two calcium carbonate tablets (800 mg of elemental calcium) resulted in a decrease in urinary phosphorus excretion of 31 mg (1.0 mmol) compared with control, whereas six calcium acetate tablets reduced urinary phosphorus by 132 mg (4.3 mmol) [22 mg (0.71 mmol) per tablet]. In another study21 the calculated reduction in 24-h urinary excretion of phosphate after 6 days of treatment was 66 mg (2.1 mmol) per 1000 mg of elemental calcium compared with 32 mg (1.0 mmol) per 1000 mg of SH.…”

Section: Discussionmentioning

confidence: 96%

Lanthanum Carbonate Reduces Urine Phosphorus Excretion: Evidence of High-Capacity Phosphate Binding

Pennick¹,

Poole²,

Dennis³

et al. 2012

Renal Failure

View full text Add to dashboard Cite

The effectiveness of phosphate binders can be assessed by evaluating urinary phosphorus excretion in healthy volunteers, which indicates the ability of the phosphate binder to reduce gastrointestinal phosphate absorption. Healthy volunteers were enrolled into one of five separate randomized trials; four were open label and one double blind. Following a screening period of <28 days, participants received differing tablets containing lanthanum carbonate [LC, 3000 mg/day of elemental lanthanum (in one study other doses were also used)]. Participants received a standardized phosphate diet and remained in the relevant study center throughout the duration of each treatment period. The end point in all studies was the reduction in urinary phosphorus excretion. Reductions in mean 24-h urinary phosphorus excretion in volunteers receiving a lanthanum dose of 3000 mg/day were between 236 and 468 mg/day over the five separate studies. These data in healthy volunteers can be used to estimate the amount of reduction of dietary phosphate absorption by LC. The reduction in 24-h urinary phosphorus excretion per tablet was compared with published data on other phosphate binders. Although there are limitations, evidence suggests that LC is a very effective phosphate binder in terms of binding per tablet.

show abstract

Section: Discussionmentioning

confidence: 96%

Lanthanum Carbonate Reduces Urine Phosphorus Excretion: Evidence of High-Capacity Phosphate Binding

Pennick¹,

Poole²,

Dennis³

et al. 2012

Renal Failure

View full text Add to dashboard Cite

show abstract

“…6 Lanthanum carbonate and sevelamer HCl are commercially available calcium-free binders that provide a lower calcium load and may be advantageous in already calcified patients or patients with higher-than-target calcium levels. [15][16][17] Sevelamer in particular slows vascular calcification in pre-dialysis and dialysis patients, and may target additional risk factors. 16,18,19 Thus, sevelamer lowers LDL cholesterol.…”

Section: Discussionmentioning

confidence: 99%

Hyperphosphatemia and hyperparathyroidism in incident chronic kidney disease patients

Ramos

Albalate

Vázquez

et al. 2008

Kidney International

View full text Add to dashboard Cite

show abstract

“…A recent study [19] reported Ca Abs over a range of intake of 1,200-3,000 mg/day normally distributed over 3 meals per day with the results depicted as 'Heidelberg data' in figure 1 . These data were obtained from normal subjects so that the coordinates of the 3 points in figure 1 indicate virtually perfect correlation with the modeled relationships, since they fall on the modeling line for normal C p D 3 2OH of 30-40 pg/ml [20,21] .…”

Section: Calcium Absorptionmentioning

confidence: 99%

Calcium Balance in Dialysis Is Best Managed by Adjusting Dialysate Calcium Guided by Kinetic Modeling of the Interrelationship between Calcium Intake, Dose of Vitamin D Analogues and the Dialysate Calcium Concentration

Gotch

Levin

Kotanko³

2010

Blood Purif

View full text Add to dashboard Cite

Calcium mass balance (Ca_MB) is determined by the difference between Ca absorbed between dialyses (Ca_Abs) and the Ca removed during dialysis (J_dCa²⁺). A mathematical model to quantify (1) Ca_Abs as a function of Ca intake (Ca_INT) and the doses of vitamin D analogues, and (2) J_dCa²⁺ as a function of Ca²⁺ dialysance, the mean plasma Ca²⁺ (_MC_piCa²⁺) minus dialysate Ca²⁺ (C_diCa²⁺), ultrafiltration rate (Q_f) and treatment time is developed in this paper. The model revealed a basic design flaw in clinical studies of Ca-based as opposed to non-Ca-based binders in that C_diCa²⁺ must be reduced with the Ca-based binders in order to avoid a positive Ca_MB relative to the non-Ca-based binders. The model was also used to analyze Ca_MB in 320 Renal Research Institute hemodialysis patients and showed that all patients irrespective of type of binder were in positive Ca_MB between dialyses (mean ± SD 160 ± 67 mg/day) with current doses of vitamin D analogues prescribed. Calculation of the optimal C_diCa²⁺ for the 320 Renal Research Institute patients revealed that in virtually all instances, the C_diCa²⁺ required for neutral Ca_MB, where Ca removal during dialysis was equal to Ca accumulation between dialyses, was less than 2.50 mEq/l and averaged about 2.00 mEq/l. This sharply contradicts the recent KDIGO (Kidney Disease: Improving Global Outcomes) Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease – Mineral and Bone Disorder, that suggests a C_diCa²⁺ of 2.5–3.0 mEq/l. Review of the KDIGO work group discussions shows that this discrepancy stems from the unwarranted work group assumption that intradialytic Ca_MB is zero. We strongly believe that this guideline for dialysate Ca²⁺ is inappropriate and should be modified to more realistically reflect the needs of dialysis patients.

show abstract

Calcium load during administration of calcium carbonate or sevelamer in individuals with normal renal function

Abstract: Intake of calcium carbonate compared to placebo in contrast to sevelamer in healthy individuals was associated with increased total urinary calcium excretion indicating an increased calcium load due to increased intestinal calcium absorption.

Cited by 16 publications

References 13 publications

Lanthanum Carbonate Reduces Urine Phosphorus Excretion: Evidence of High-Capacity Phosphate Binding

Lanthanum Carbonate Reduces Urine Phosphorus Excretion: Evidence of High-Capacity Phosphate Binding

Hyperphosphatemia and hyperparathyroidism in incident chronic kidney disease patients

Calcium Balance in Dialysis Is Best Managed by Adjusting Dialysate Calcium Guided by Kinetic Modeling of the Interrelationship between Calcium Intake, Dose of Vitamin D Analogues and the Dialysate Calcium Concentration

Contact Info

Product

Resources

About