Comparison of the effects of Ca-mg carbonate chewable tablets with calcium carbonate tablets on phosphate binding in patients on hemodialysis taking H2-R blockers

Abstract EN

Objectives: Calcium carbonate/magnesium carbonate (CaCO3/MgCO3) combination chewable tablets may be an attractive alternative phosphate binder to calcium carbonate (CaCO3) tablets with potential advantages of synergistic phosphate binding effect.

The aim of this study is to evaluate the differences between the two phosphate binders on 42 hemodialysis patients who are taking H2-Blockers in terms of serum PO4-3 and Mg+2levels.

Methods: Randomized, controlled, open label study was conducted at the renal /hemodialysis unit of King Hussein Medical Center for six weeks (On May 2018).

After the study was approved, patients who met the inclusion criteria were enrolled and were randomly allocated into an interventional group (Group I) and a control group (Group II).

Follow-up continued for 6 weeks.

The collected data were statistically analyzed using the independent t-test.

Results: A total of 37 hemodialysis patients were finally included in this study.

The mean age was 40.81±2.31 years, 17 subjects (45.95%) were males, and 20 subjects (54.05%) were females.

Despite serum PO4-3 level decreased significantly in group I by -0.39±0.99 mg/dl after replacing CaCO3 tablets by CaCO3/MgCO3 in equivalent dose, the differences between two groups were statistically insignificant (- 0.094±0.213).

But when taking into consideration the incremental cost-effectiveness, the CaCO3/MgCO3 tablets are more cost effective by magnitude of 27.766 JD per week for every 1 mg/dl.

Serum magnesium level increased significantly within group I and between the two groups by +0.55±0.36 mg/dl and +0.430±0.089 mg/dl respectively.

Neither serum cCa+2 nor cCa+2 ×PO4 -3 products were changed significantly either among or between the two groups.

Conclusion: No significant difference was detected between Ca-Mg carbonate chewable tablets and the less expensive Ca carbonate tablets in reducing serum phosphate levels in hemodialysis patients on H2-R blockers