COMPARISON OF CALCIUM ACETATE WITH CALCIUM CARBONATE AS PHOSPHATE BINDER IN PATIENTS ON MAINTENANCE HAEMODIALYSIS
AbstractBackground: Hyperphosphatemia is common in end-stage renal disease patients. Objective ofthis study is to compare the hypercalcaemic effect and phosphate binding power of calciumacetate and calcium carbonate in end-stage renal disease patients on maintenance haemodialysis.Methods: This randomised control trial was conducted in four phases with calcium acetate orcalcium carbonate. Sixty-four patients on haemodialysis were randomly divided into 2 groups.After a washout period of 2 weeks, each group was given calcium acetate or calcium carbonatefor 2 months. After another washout period the patients were crossed over and again receivedthese drugs for 2 months. Serum Calcium, phosphate, and albumin were analysed on Selectra Eauto analyser at completion of each phase of study. Hypercalcaemic effect was defined as serumcalcium >2.54 mmol/l, and phosphate binding power as serum phosphate <1.61 mmol/l. Results:Forty-one patients completed the study. Though lower dose of calcium acetate was used, itresulted in equally good control of hyperphosphatemia as compared with calcium carbonatetherapy [1.37 mmol/l (SD 0.33) vs. 1.46 mmol/l (SD 0.34), p=0.16]. Incidence of hypercalcaemiawas higher with calcium carbonate therapy (2.730.67 mmol/l vs. 2.320.28 mmol/l, p<0.01).Both drugs were well tolerated, but patients more frequently complained of muscle cramps whiletaking calcium acetate. Conclusions: It is concluded that calcium acetate has similar effect onserum phosphate levels as compared to calcium carbonate in patients on maintenancehaemodialysis. However, calcium acetate results in lesser frequency of hypercalcaemia ascompared to calcium carbonate. Tolerance to both drugs was similar, though patients complainedof more muscle cramps while taking calcium acetate.KEY WORDS: Calcium acetate, Calcium carbonate, Hyperphosphatemia
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