Background: Hyperphosphatemia in patients with chronic kidney disease (CKD) contributes to secondary hyperparathyroidism, soft tissue calcification, and increased mortality risk. This trial was conducted to examine the efficacy and safety of calcium acetate in controlling serum phosphorus in pre-dialysis patients with CKD.
Methods: In this randomized, double-blind, placebo-controlled trial, 110 nondialyzed patients from 34 sites with estimated GFR < 30 mL/min/1.73 m² and serum phosphorus > 4.5 mg/dL were randomized to calcium acetate or placebo for 12 weeks. The dose of study drugs was titrated to achieve target serum phosphorus of 2.7-4.5 mg/dL. Serum phosphorus, calcium, iPTH, bicarbonate and serum albumin were measured at baseline and every 2 weeks for the 12 week study period. The primary efficacy endpoint was serum phosphorus at 12 weeks. Secondary endpoints were to measure serum calcium and intact parathyroid hormone (iPTH) levels.
Results: At 12 weeks, serum phosphorus concentration was significantly lower in the calcium acetate group compared to the placebo group (4.4 ± 1.2 mg/dL vs. 5.1 ± 1.4 mg/dL; p = 0.04). The albumin-adjusted serum calcium concentration was significantly higher (9.5 ± 0.8 vs. 8.8 ± 0.8; p < 0.001) and iPTH was significantly lower in the calcium acetate group compared to placebo (150 ± 157 vs. 351 ± 292 pg/mL respectively; p < 0.001). At 12 weeks, the proportions of subjects who had hypocalcemia were 5.4% and 19.5% for the calcium acetate and the placebo groups, respectively, while the proportions of those with hypercalcemia were 13.5% and 0%, respectively. Adverse events did not differ between the treatment groups.
Conclusions: In CKD patients not yet on dialysis, calcium acetate was effective in reducing serum phosphorus and iPTH over a 12 week period.
Trial Registration: www.clinicaltrials.gov NCT00211978.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055808 | PMC |
| http://dx.doi.org/10.1186/1471-2369-12-9 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association between waist-to-height ratio and osteoporosis in the National Health and Nutrition Examination Survey: a cross-sectional study.
Front Med (Lausanne)
December 2024
Department of Orthopedics, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.
Background: The link between waist-to-height ratio (WHtR) and osteoporosis (OP) remains a contentious issue in the field of medical research. Currently, the available evidence on this association is deemed insufficient. This topic has garnered significant attention and is a focal point of ongoing investigations.
View Article and Find Full Text PDFAssociation of Vitamin D Deficiency with Late Onset Neonatal Sepsis in Term and Late Preterm Neonates.
Mymensingh Med J
January 2025
Dr Md Arif Rabbany, Junior Consultant, Department of Neonatology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
Sepsis is a leading cause of neonatal morbidity and mortality worldwide, especially in low- and middle- income countries (LMIC). It is estimated to cause almost 1 million deaths that accounts for more than 25.0% of neonatal deaths worldwide.
View Article and Find Full Text PDFVitamin D: an important treatment for secondary hyperparathyroidism in chronic kidney disease?
Int Urol Nephrol
December 2024
Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, China.
Secondary hyperparathyroidism (SHPT) is one of the most common complications of chronic kidney disease (CKD). Vitamin D levels begin to decrease in the early stages of CKD, and these vitamin D-related changes play a central role in the occurrence and development of SHPT. Vitamin D-based drugs, which inhibit parathyroid hormone secretion either directly or indirectly, are commonly used to treat SHPT.
View Article and Find Full Text PDFBone and Joint Involvement in Beta Thalassemic Patients: A Cross-sectional Study.
Indian J Orthop
January 2025
Dayanand Medical College and Hospital, Tagore Nagar, civil lines, Ludhiana, Punjab 141001 India.
Purpose: There is paucity of guidelines with inadequate data available about the extent and prevention of bone and joint disease in beta-thalassemic patients in Indian population. This study aims to determine bone and joint involvement in beta-thalassemic patients. It evaluates serum biochemical parameters of bone formation and resorption and correlates with the symptomatology in these patients.
View Article and Find Full Text PDFEvaluating Neutrophil Gelatinase-Associated Lipocalin in Pediatric CKD: Correlations with Renal Function and Mineral Metabolism.
Pediatr Rep
December 2024
Department of Pediatrics, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Background: Pediatric chronic kidney disease (CKD) requires reliable biomarkers for early detection and monitoring. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as a potential marker due to its responsiveness to renal impairment and involvement in mineral metabolism.
Objectives: To evaluate serum NGAL levels in pediatric CKD patients and explore correlations with estimated glomerular filtration rate (eGFR), ferritin, calcium-phosphorus (Ca*P) product, and total serum protein.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!