Efficacy and safety of calcium acetate-magnesium carbonate in the teatment of hyperphosphatemia in dialysis patients

Abstract EN

A phosphate binder combining calcium and magnesium offers an interesting therapeutic option to control hyperphosphatemia in dialysis patients.

We investigated the effectiveness and tolerance of calcium acetate–magnesium carbonate (Ca–Mg).

This is a 16-week prospective study including 16 dialysis patients.

After an initial two-week washout period, serum phosphorus (sPho) ≥1.8 mmol/L, serum calcium (sCa) ≤2.6 mmol / L, and serum magnesium ≤1.5 mmol/L were the main inclusion criteria.

The initial dose of Ca–Mg depended on sPho level and was titrated for every two weeks to have a sPho ≤1.8 mmol/L.

A second two-week washout period followed the 12 weeks of treatment.

Ca–Mg significantly reduced the mean sPho levels from 2.14 to 1.75 mmol/L by the end of the 12-week treatment period (P < 0.006) Two weeks after the completion of the Ca–Mg study, the mean sPho levels increased to 2.2 mmol/L.

The mean sCa levels did not significantly change during the Ca–Mg trial.

The mean serum intact parathyroid hormone declined significantly from 446 pg/mL at the beginning of the study to 367 pg/mL at the end of the 12-week treatment period (P = 0.0002).

Digestive tolerance was good in all patients which allowed good compliance.

There were no episodes of hypercalcemia.

However, six patients had a moderate hypermagnesemia (21 episodes) requiring adjustment of treatment dose.

The Ca–Mg proved to be effective in the control of hyperphosphatemia in dialysis patients with good clinical and biological tolerance.

Thus, in patients with hypercalcemia or poor tolerance to calcium carbonate, Ca–Mg might be a good alternative.