Journal ArticleDOI
Effect of the time of administration of calcium acetate on phosphorus binding.
Reads0
Chats0
TLDR
It is concluded that calcium acetate increases fecal excretion of phosphorus by binding both dietary and endogenous phosphorus, but the binding of dietary phosphorus is quantitatively much more important.Abstract:
Phosphorus binders are given to patients with renal failure to increase gastrointestinal excretion of phosphorus. To determine the relative importance of the binding of dietary as compared with endogenous phosphorus and to determine the optimal dose schedule, we gave either 4.4 g of calcium acetate (25 mmol of calcium) or a placebo to six normal subjects on each of seven different schedules in a randomized sequence. The net gastrointestinal balance of phosphorus and calcium was determined by a one-day lavage technique. After a meal containing approximately 12 mmol of phosphorus, the mean phosphorus absorption (+/- SE) measured 9.17 +/- 0.36 mmol (78 percent) with placebo but decreased to 3.81 +/- 0.58 mmol (31 percent) when calcium acetate was given immediately before the meal (representing binding of 5.36 +/- 0.77 mmol of phosphorus). Similar binding was observed when calcium acetate was given immediately after the meal and when half the dose was given before and half after the meal. In contrast, when calcium acetate was given two hours after the meal or while the subject was fasting, phosphorus binding was reduced to 2.00 +/- 0.52 mmol and 1.81 +/- 0.84 mmol, respectively. Calcium absorption from calcium acetate averaged 21 +/- 1 percent when the binder was given with a meal; absorption from calcium acetate averaged 40 +/- 4 percent when the binder was given while the subject was fasting. We conclude that calcium acetate increases fecal excretion of phosphorus by binding both dietary and endogenous phosphorus, but the binding of dietary phosphorus is quantitatively much more important. For the most efficient phosphorus binding, calcium (and presumably other phosphorus-binding cations) should be given with meals.read more
Citations
More filters
Journal ArticleDOI
Bone metabolism and disease in chronic kidney disease
Journal ArticleDOI
Renal bone disease 1990: an unmet challenge for the nephrologist.
TL;DR: A rational approach to the treatment of renal bone disease requires a basic understanding of the anatomic physiology of bone, the pathophysiologic effects of renal failure on mineral metabolism and bone, and the various available therapeutic modalities.
Dietary Reference Intakes
TL;DR: The development of DRIs replaces the periodic revisions of Recommended Dietary Allowances (RDAs), which have been published since 1941 by the National Academy of Sciences.
Journal ArticleDOI
Clinical Practice Guideline for the Management of Chronic Kidney Disease-Mineral and Bone Disorder
Masafumi Fukagawa,Keitaro Yokoyama,Fumihiko Koiwa,Masatomo Taniguchi,Tetsuo Shoji,Junichiro James Kazama,Hirotaka Komaba,Ryoichi Ando,Takatoshi Kakuta,Hideki Fujii,Msasaaki Nakayama,Yugo Shibagaki,Seiji Fukumoto,Naohiko Fujii,Motoshi Hattori,Akira Ashida,Kunitoshi Iseki,Takashi Shigematsu,Yusuke Tsukamoto,Yoshiharu Tsubakihara,Tadashi Tomo,Hideki Hirakata,Tadao Akizawa +22 more
TL;DR: CKD-MBD Guideline Working Group, Japanese Society for Dialysis Therapy, and Tadao Akizawa thank the authors for their help and assistance in the development of this guideline.
References
More filters
Journal ArticleDOI
The dialysis encephalopathy syndrome. Possible aluminum intoxication.
TL;DR: The fact that brain gray-matter aluminum was higher in all patients with the dialysis-associated encephalopathy syndrome than any of the control subjects or other uremic patients on dialysis suggests that this syndrome may be due to aluminum in intoxication.
Journal ArticleDOI
Calcium Carbonate as a Phosphate Binder in Patients with Chronic Renal Failure Undergoing Dialysis
Eduardo Slatopolsky,Carol Weerts,S. Lopez-Hilker,Kathryn Norwood,Mary Zink,David W. Windus,James A. Delmez +6 more
TL;DR: Calcium carbonate successfully lowered serum phosphorus levels and raised serum calcium levels in the majority of the authors' patients, thereby confirming that this agent may be a satisfactory substitute for traditional phosphate binders that contain aluminum.
Journal ArticleDOI
Bone Aluminum and Histomorphometric Features of Renal Osteodystrophy
Anthony B. Hodsman,Donald J. Sherrard,Allen C. Alfrey,Susan M. Ott,Arnold S. Brickman,Nancy L. Miller,Norma A. Maloney,Jack W. Coburn +7 more
TL;DR: Findings are consistent with but do not prove the hypothesis that aluminum plays a pathogenic role in dialysis osteomalacia; the mechanism by which aluminum accumulates remains unknown.
Journal ArticleDOI
Reduction of dietary phosphorus absorption by phosphorus binders. A theoretical, in vitro, and in vivo study.
M S Sheikh,John A. Maguire,M Emmett,C A Santa Ana,Michael J. Nicar,Lawrence R. Schiller,John S. Fordtran +6 more
TL;DR: Cal calcium acetate, not previously used for medical purposes, is approximately as efficient as aluminum carbonate gel and more efficient as a phosphorus binder than other currently used calcium salts.