Long-term administration of calcium acetate efficiently controls severe hyperphosphataemia in haemodialysis patients

In order to avoid aluminium toxicity, calcium-containing phosphate binders have been used increasingly. Unfortunately, calcium carbonate and calcium citrate produce hypercalcaemia in a number of patients. New studies have shown that calcium acetate is promising in that it binds more phosphate than calcium carbonate at comparable doses. We tested calcium acetate in eight severely hyperphosphataemic patients (2.25 +/- 0.08 mmol/l) on maintenance haemodialysis over 5 months. Serum phosphate decreased to 1.86 +/- 0.06 mmol/l, but at the cost of an increase in serum calcium. However, the increment of serum calcium was always less than the respective decrease of serum phosphate, and hypercalcaemia-immediately reversible after dose reduction-only occurred once in two patients.