Calcium Acetate versus Calcium Carbonate as Phosphate Binders in Hemodialysis Patients

Nephron ◽  
1992 ◽  
Vol 60 (4) ◽  
pp. 423-427 ◽  
Author(s):  
F. Caravaca ◽  
I. Santos ◽  
J.J. Cubero ◽  
J.F. Esparrago ◽  
M. Arrobas ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Hemodialysis Patients ◽  
Calcium Acetate ◽  
Phosphate Binders

Calcium acetate versus calcium carbonate as oral phosphate binder in pediatric and adolescent hemodialysis patients

1996 ◽  
Vol 10 (5) ◽  
pp. 625-630 ◽  
Author(s):  
Michael Wallot ◽  
Klaus-Eugen Bonzel ◽  
Andreas Winter ◽  
Birgit Geörger ◽  
Bernhard Letten ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Phosphate Binder ◽  
Hemodialysis Patients ◽  
Calcium Acetate

scholarly journals Calcium Acetate or Calcium Carbonate for Hyperphosphatemia of Hemodialysis Patients: A Meta-Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (3) ◽  
pp. e0121376 ◽  
Author(s):  
Yong Wang ◽  
Guoqiang Xie ◽  
Yuanhang Huang ◽  
Han Zhang ◽  
Bo Yang ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Meta Analysis ◽  
Hemodialysis Patients ◽  
Calcium Acetate

scholarly journals Calcium acetate versus calcium carbonate in the control of hyperphosphatemia in hemodialysis patients

2000 ◽  
Vol 118 (6) ◽  
pp. 179-184 ◽  
Author(s):  
Eufrônio José d'Almeida Filho ◽  
Elisa de Albuquerque Sampaio da Cruz ◽  
Marcos Hoette ◽  
Frederico Ruzany ◽  
Luana Neves Lopes Keen ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Statistical Significance ◽  
Blood Gas Analysis ◽  
Good Alternative ◽  
Hemodialysis Patients ◽  
Gas Analysis ◽  
Calcium Acetate ◽  
Double Blind Study ◽  
Double Blind ◽  
Stage Renal Disease

CONTEXT: Hyperphosphatemia has an important role in the development of bone and mineral abnormalities in end-stage renal disease (ESRD). OBJECTIVE: To compare the phosphorus binding power and the hypercalcemic effect of calcium acetate and calcium carbonate in hemodialysis patients. TYPE OF STUDY: Crossover, randomized, double-blind study. PLACE: A private hospital dialysis center. PARTICIPANTS: Fifty-two patients who were undergoing regular hemodialysis three times a week ([Ca++] dialysate = 3.5 mEq/L). PROCEDURES: Half of the patients were started on 5.6 g/day of calcium acetate and, after a 2 week washout period, received 6.2 g/day of calcium carbonate. The other half followed an inverse protocol. MAIN MEASUREMENTS: Clinical interviews were conducted 3 times a week to monitor for side effects. Determinations of serum urea, calcium, phosphorus, hematocrit, Kt/V and blood gas analysis were obtained before and after each treatment. RESULTS: Twenty-three patients completed the study. A significant increase in calcium plasma levels was only observed after treatment with calcium carbonate [9.34 mg/dl (SD 0.91) vs. 9.91 mg/dl (SD 0.79), P < 0.01]. The drop in phosphorus levels was substantial and significant for both salts [5.64 mg/dl (SD 1.54) vs. 4.60 mg/dl (SD 1.32), P < 0.01 and 5.89 mg/dl (SD 1.71) vs. 4.56 mg/dl (SD 1.57), P < 0.01, for calcium acetate and calcium carbonate respectively]. The percentage reduction in serum phosphorus (at the end of the study) per milliequivalent of salt administered per day tended to be higher with calcium acetate but statistical significance was not found. CONCLUSION: Calcium acetate can be a good alternative to calcium carbonate in the handling of hyperphosphatemia in ESRD patients. When calcium acetate is used, control of hyperphosphatemia can be achieved with a lower administration of calcium, perhaps with a lower risk of hypercalcemia.

scholarly journals Gut microbiome in hemodialysis patients treated with calcium acetate or treated with sucroferric oxyhydroxide: a pilot study

2021 ◽  
Author(s):  
Ana Merino-Ribas ◽  
Ricardo Araujo ◽  
Ioana Bancu ◽  
Fredzzia Graterol ◽  
Andrea Vergara ◽  
...  
Keyword(s):  
Gut Microbiome ◽  
Hemodialysis Patients ◽  
Calcium Acetate ◽  
Phosphate Binders ◽  
Bacterial Composition ◽  
Hypervariable Regions ◽  
Rrna Sequencing ◽  
Sequencing Library ◽  
Stool Samples ◽  
To Receive

Abstract Purpose It has been proved that the gut microbiome is altered in patients with chronic kidney disease. This contributes to chronic inflammation and increases cardiovascular risk and mortality, especially in those undergoing hemodialysis. Phosphate binders may potentially induce changes in their microbiome. This trial aimed to compare the changes in the gut microbiome of hemodialysis patients treated with calcium acetate to those treated with sucroferric oxyhydroxide. Methods Twelve hemodialysis patients were distributed to receive calcium acetate or sucroferric oxyhydroxide for 5 months. Blood samples (for biochemical analysis) and stool samples (for microbiome analysis) were collected at baseline, 4, 12, and 20 weeks after treatment initiation. Fecal DNA was extracted and a 16S rRNA sequencing library was constructed targeting the V3 and V4 hypervariable regions. Results Regarding clinical variables and laboratory parameters, no statistically significant differences were observed between calcium acetate or sucroferric oxyhydroxide groups. When analyzing stool samples, we found that all patients were different (p = 0.001) among themselves and these differences were kept along the 20 weeks of treatment. The clustering analysis in microbial profiles grouped the samples of the same patient independently of the treatment followed and the stage of the treatment. Conclusion These results suggest that a 5-month treatment with either calcium acetate or sucroferric oxyhydroxide did not modify baseline diversity or baseline bacterial composition in hemodialysis patients, also about the high-variability profiles of the gut microbiome found among these patients.

P0272COMPARATIVE GUT MICROBIOME DIFFERENCES BETWEEN FERRIC CITRATE AND CALCIUM CARBONATE PHOSPHATE BINDER TREATMENT IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ping-Hsun Wu ◽  
Yi-Ting Lin ◽  
Po-Yu Liu ◽  
Mei-Chuan Kuo ◽  
Yi wen Chiu
Keyword(s):  
Calcium Carbonate ◽  
Gut Microbiome ◽  
Phosphate Binder ◽  
Hemodialysis Patients ◽  
Ferric Citrate ◽  
Phosphate Binders ◽  
Uremic Toxin ◽  
Phosphate Binding ◽  
Microbial Composition ◽  
Linear Discriminant

Abstract Background and Aims Gut microbiome alteration increases uremic toxin levels inducing chronic inflammation and leading morbidity and mortality in patients with chronic kidney disease. Phosphate-binding agents may potentially change the composition of the gut microbiota. However, the limited clinical study investigates the microbiome difference between iron-containing and calcium-containing phosphate binders. The aim of this study was to compare the microbiota composition in hemodialysis patients treated with ferric citrate or calcium carbonate. Method The stool microbiota was investigated in hemodialysis patients with ferric citrate used (n=8) and calcium carbonate used (n=46) by 16S rRNA next-generation gene sequencing profiling. The altered microbiota between two different phosphate binders was analyzed. Differences in the microbial composition of the two patient groups were assessed using linear discriminant analysis effect size. Results Hemodialysis patients with calcium carbonate used revealed significantly reduced microbial species diversity (Shannon index and Simpson index) and increased microbial dysbiosis index compared with ferric citrate users. Compared to patients taking calcium carbonate, a distinct microbial community structure in patients taking ferric citrate, with an increased abundance of Bacteroidetes phylum and decreased abundance of phylum Firmicutes. In comparison between two phosphate binder users, members of the order Lactobacillales were prominent in calcium carbonate therapy, including family Streptococcaceae and genus Streptococcus. In contrast, taxa of the genus Ruminococcaceae, Flavonifractor, and Cronobacter were enriched in ferric citrate phosphate binder users. Conclusion The fecal microbiota was richer and more diverse in the ferric citrate group than in the calcium carbonate group. Hemodialysis patients with ferric citrate used were associated with differences in the gut microbiome composition compared to calcium carbonate users.

scholarly journals Comparative Gut Microbiome Differences between Ferric Citrate and Calcium Carbonate Phosphate Binders in Patients with End-Stage Kidney Disease

2020 ◽  
Vol 8 (12) ◽  
pp. 2040
Author(s):  
Ping-Hsun Wu ◽  
Po-Yu Liu ◽  
Yi-Wen Chiu ◽  
Wei-Chun Hung ◽  
Yi-Ting Lin ◽  
...  
Keyword(s):  
Calcium Carbonate ◽  
Kidney Disease ◽  
Gut Microbiome ◽  
Phosphate Binder ◽  
Hemodialysis Patients ◽  
Ferric Citrate ◽  
Phosphate Binders ◽  
Rrna Gene ◽  
Phosphate Binding ◽  
Linear Discriminant

Gut dysbiosis in patients with chronic kidney disease (CKD) may induce chronic inflammation and increase morbidity. Phosphate-binding agents, generally used in patients with CKD, may potentially change the composition of the gut microbiota. This study aimed to compare the microbiota composition in hemodialysis patients treated with ferric citrate or calcium carbonate. The stool microbiota was investigated in hemodialysis patients treated with ferric citrate (n = 8) and calcium carbonate (n = 46) using 16S rRNA gene amplicon sequencing profiling using linear discriminant analysis of effect size. Further predictive functional profiling of microbial communities was obtained with Tax4Fun in R. Hemodialysis patients treated with calcium carbonate had a significantly reduced microbial species diversity (Shannon index and Simpson index) and an increased microbial alteration ratio compared with patients treated with ferric citrate. A distinct microbial community structure was found in patients treated with ferric citrate, with an increased abundance of the Bacteroidetes phylum and a decreased abundance of the phylum Firmicutes. Members of the order Lactobacillales were enriched in patients treated with calcium carbonate, whereas taxa of the genera Ruminococcaceae UCG-004, Flavonifractor, and Cronobacter were enriched in patients treated with ferric citrate phosphate binder. In conclusion, Ferric citrate therapy results in a more diverse microbiome community compared to calcium carbonate therapy in hemodialysis patients with phosphate binder treatment. The gut microbiome reflects the phosphate binder choice in hemodialysis patients, further affecting the physiological environment in the gastrointestinal tract.

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