Calcium carbonate has fallen out of favor as a phosphate-binder in chronic kidney disease due to its association with hypercalcemia and calcium toxicity. - GreenMedInfo Summary
Phosphate binders in CKD: chalking out the differences.
Pediatr Nephrol. 2010 Mar;25(3):385-94. Epub 2009 Nov 7. PMID: 19898877
Department of Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, UK. [email protected]
Plasma phosphate levels are important in the evolution of hyperparathyroidism and ectopic calcification in chronic kidney disease (CKD). Although dietary management may be adequate to control plasma phosphate in its early stages, most patients develop hyperphosphataemia by CKD stages 3-4 and require the addition of a phosphate binder. Calcium-containing phosphate binders are the most used and cheapest binders but have fallen out of favour because of the potential for positive calcium balance and calcium toxicity. This problem may be attenuated by newer phosphate binders such as sevelamer hydrochloride and lanthanum carbonate. In this review, the role of phosphate as a uraemic toxin and the advantages and disadvantages of the currently available phosphate binders are discussed.