English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Robert L. Lins, MD, Department of Nephrology and Hypertension A.Z. Stuivenberg, Lange Beeldekensstraat 267, B-2008 Antwerp (Belgium) In a recent editorial about the treatment of uremic hyperphosphatemia, Schaefer et al. [1] wondered if calcium-free dialysate could reduce the potential risks of therapy with CaC03. Although no published studies about the use of calcium-free dialysate exist, there are some reports about using low-calcium dialysate (LCD) [2–4]. Mactier et al. [2] concluded that in most hemodialysis patients CaC03 could effectively prevent hyperphosphatemia without the risk of hypercalcemia, using LCD. Our results of a prospective study [3, 4], using LCD (2,5 mEq/1) in 7 patients who previously developed hypercalcemia when regular calcium dialysate (RCD; 3.75 mEq/ 1) was used, differ somewhat from those of Mactier. Although the intake of Al(OH)3 could be significantly decreased and that of CaC03 increased, the average cal-cemia, number of hypercalcemic episodes and control of serum phosphate were not significantly different comparing RCD and LCD periods. Moreover, the dose to control phosphatemia was 3 times higher for CaC03 than for Al(OH)3, resulting in poor patient compliance. While increasing the dose of CaCC > 3, considerable fluctuations of serum phosphate and calcium were seen, necessitating frequent serum determinations. In our own (3 months) as well as in the study by Mactier et al., the follow-up period might have been too short. Sometimes there was a delay of several weeks between changing CaC03 intake and stabilization of serum calcium levels. We are aware that factors like vitamin D intake, parathyroid and aluminum burden will considerably influence the results. Therefore we believe that our own results and those of Mactier et al., suggest that probably a subgroup of patients will benefit from CaCC > 3 as a phosphate binder using low-calcium or even calcium-free dialysate. Long-term studies with a greater number of patients have to be done to confirm this. References Schaefer K, von Herrath D, Myrthe Erley CM: Treatment of uremic hyperphosphatemia. Is there still a need for aluminum salts? Am J Nephrol 1988;8:173–178.

Calcium Carbonate as Phosphate Binder in Patients on Low-Calcium Dialysate