CALCIUM ACETATE FOR PHOSPHATE-BINDING IN HEMODIALYSIS-PATIENTS WITH HYPERPHOSPHATEMIA RESISTANT TO THERAPY

20 hemodialysis patients (age xBAR = 58.9 +/- 14.8 years, 10 male patients, dialysis since xBAR = 45.9 +/- 39.4 months) with more than six months lasting hyperphosphatemia and serum-phosphate levels higher than 2 mmol/l, wich was refractory to usual phosphate binding therapy, were selected from our 217 ambulatory hemodialysis patients. The chronic treatment with calcium gluconate, calcium carbonate or aluminiumhydroxide was changed to calcium acetate (CA), using identical numbers of tablets (xBAR = 5.6 tabl./day: containing 616 mg elementary calcium). During 4 months of treatment. CA was prescribed in the 2nd and 4th month, the former phosphate binders in the 1st and 3rd. Under the administration of Ca, there was a decrease of S-phosphate levels in comparison with the former phosphate binders (2.15 +/- 0.37 versus 2.29 +/- 0.32 mmol/l), the calcium-phosphate product was slightly ameliorated 15.18 +/- 0,88 versus 5.49 +/- 0.76 mmol/l). calcium concentration (2.42 +/- 0.15 versus 2,40 +/- 0.15 mmol/l). standard bicarbonate and serum pH did not change. As a new phosphate binder, CA was superior to Ca-gluconate, and, in single cases, more effective than Ca-carbonate and even aluminumhydroxide. In conclusion, patients with poor compliance and severe hyperphosphatemia may benefit from treatment with calcium acetate.