Treatment of uraemic hyperphosphatemia with calcium acetate: a safe alternative to calcium carbonate.

Clinical usefulness of calcium acetate (CAA) as phosphorus binder was assessed in 19 stable hemodialysis patients with persistent hyperphosphatemia. All were dialysed thrice weekly with a constant dialytic schedule and a dialysate calcium of 3.5 mEq/l. One month prior the study beginning all patients stopped assumption of Ca and vitamin D supplements. In the first period of the study CAA (mean daily doses 2.2 g) was administered for one month followed by 15 days of withdrawal. The mean serum phosphorus decreased from 7.6 ±1.4 to 5.8 ±0.8 mg% (p<0.005). After 15 days of withdrawal mean serum phosphorus reached the pretreatment value. Then the patients entered a long term study with personalized doses of CAA (between 1 and 4 g/day) and administration in 8 of them of alpha-calcidol. After a mean follow-up period of 5.4 ±1.5 months serum phosphorus was reduced from 7.5 ±1.1 to 5.6 + 1.1 mg% (p<0.0005) while calcemia increased from 9.0 ±0.7 to 9.6 ± 0.6 mg% (p<0.005). Only one patient developed mild hypercalce...