Randomized crossover study comparing the phosphate-binding efficacy of calcium ketoglutarate versus calcium carbonate in patients on chronic hemodialysis.
The objective of the study was to evaluate the phosphate-binding efficacy, side effects, and cost of therapy of calcium ketoglutarate granulate as compared with calcium carbonate tablets in patients on chronic hemodialysis.
The study design used was a randomized, crossover open trial, and the main outcome measurements were plasma ionized calcium levels, plasma phosphate levels, plasma Intact parathyroid hormone (PTH) levels, requirements for supplemental aluminum-aminoacetate therapy, patient tolerance, and cost of therapy.
Nineteen patients on chronic hemodialysis were treated with a dialysate calcium concentration of 1.25 mmol/L and a fixed alfacalcidol dose for at least 2 months.
All had previously tolerated therapy with calcium carbonate.
Of the 19 patients included, 10 completed both treatment arms.
After 12 weeks of therapy, the mean (±SEM) plasma ionized calcium level was significantly lower In the ketoglutarate arm compared with the calcium carbonate arm (4.8 ± 0.1 mg/dL v5.2 ± 0.1 mg/dL ; P=0.004), whereas the mean plasma phosphate (4.5 ± 0.3 mg/dL v5.1 ± 0.1 mg/dL) and PTH levels (266 ± 125 pg/mL v 301 ± 148 pg/mL) did not differ significantly between the two treatment arms.
Supplemental aluminum-aminoacetate was not required during calcium ketoglutarate treatment, while two patients needed this supplement when treated with calcium carbonate. (...)
Mots-clés Pascal : Hémodialyse, Etude comparative, Efficacité, Liaison, Phosphate, Glutarique acide(oxo), Calcium, Carbonate organique, Effet secondaire, Coût, Essai clinique, Randomisation, Essai croisé, Epuration extrarénale, Appareil urinaire pathologie, Rein pathologie, Pharmacologie, Economie santé
Mots-clés Pascal anglais : Hemodialysis, Comparative study, Efficiency, Binding, Phosphates, Glutaric acid(oxo), Calcium, Organic carbonate, Secondary effect, Costs, Clinical trial, Randomization, Crossover study, Extrarenal dialysis, Urinary system disease, Kidney disease, Pharmacology, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0138926
Code Inist : 002B02I. Création : 21/07/1998.