Related Experiment Videos
Magnesium carbonate as a phosphorus binder: a prospective, controlled, crossover study
J A Delmez1, J Kelber, K Y Norword
1Renal Division, Washington University School of Medicine, Saint Louis, Missouri, USA.
Kidney International
|January 1, 1996
Summary
Magnesium carbonate (MgCO3) effectively controls phosphorus and magnesium levels in hemodialysis patients. It allows reduced calcium carbonate (CaCO3) intake and higher calcitriol doses, mitigating hypercalcemia risks.
Area of Science:
- Nephrology
- Clinical Nutrition
- Pharmacology
Background:
- Calcium carbonate (CaCO3) is widely used for phosphorus (P) binding in hemodialysis patients.
- Hypercalcemia is a significant limitation of CaCO3, especially with calcitriol therapy.
- A non-calcium-based P binder is needed for these patients.
Purpose of the Study:
- To evaluate the chronic efficacy of magnesium carbonate (MgCO3) as a P binder.
- To determine if MgCO3 allows reduced CaCO3 dosage while maintaining P and Mg control.
- To assess if reduced CaCO3 facilitates higher calcitriol doses without hypercalcemia.
Main Methods:
- Prospective, randomized, crossover study design.
- Two treatment phases: MgCO3 with half-dose CaCO3, and usual-dose CaCO3 alone.
- Monitoring of calcium (Ca), P, and magnesium (Mg) levels, and calcitriol dosage.
Main Results:
- MgCO3 significantly reduced daily elemental Ca intake from 2.9 to 1.2 g/day.
- Serum Ca, P, and Mg levels remained comparable between the two phases.
- Higher doses of intravenous calcitriol (1.5 µg/treatment) were tolerated during the MgCO3 phase versus the CaCO3 phase (0.8 µg/treatment).
Conclusions:
- Chronic MgCO3 use, with a dialysate Mg of 0.6 mg/dl, enables reduced CaCO3 intake.
- MgCO3 facilitates higher calcitriol doses, potentially improving management of hypercalcemia in hemodialysis patients.
- MgCO3 is a promising alternative P binder for selected hemodialysis patients experiencing hypercalcemia with CaCO3 and calcitriol.