Abstract
It has been reported that serum bicarbonate levels decrease in chronic hemodialysis patients treated with sevelamer hydrochloride, whereas these levels increase with calcium-containing phosphate binders. We investigated the effect of calcium carbonate administration on serum bicarbonate levels and metabolic acidosis in chronic hemodialysis patients treated with sevelamer hydrochloride.
Sixteen chronic hemodialysis patients were studied (M/F; 8/8, age; 51.0±9.6y, hemodialysis duration; 58.0±56.0m). All subjects were treated with sevelamer hydrochloride at 2.25g/day for 2 weeks, then increased to 2.95±1.4g/day for 2 weeks. After discontinuing sevelamer hydrochloride followed by wash out for 8 weeks, they were again treated with sevelamer hydrochloride at 2.25g/day for 2 weeks, then increased to 2.95±1.4g/day for 2 weeks with calcium carbonate at 1.5g/day. Serum bicarbonate levels were measured before hemodialysis.
Serum bicarbonate levels with sevelamer hydrochloride significantly decreased from 23.2±1.86 to 20.3±1.40 after 2 weeks (p<0.0001) and 19.9±2.07mmol/L after 4 weeks (p<0.000001). Serum bicarbonate levels with sevelamer hydrochloride and calcium carbonate also significantly decreased from 23.0±1.68 to 21.5±2.23 after 2 weeks (p<0.05) and 20.9±2.37mmol/L after 4 weeks (p<0.01) respectively. Metabolic acidosis induced by sevelamer hydrochloride was significantly mitigated by calcium carbonate (after 4 weeks with sevelamer hydrochloride vs after 4 weeks with sevelamer hydrochloride and calcium carbonate; p<0.01).
Administering calcium carbonate improves metabolic acidosis induced by sevelamer hydrochloride in hemodialysis patients.
