Slatopolsky E, Weerts C, Stokes T, Windus D, Delmez J
Semin Nephrol. 1986 Dec;6(4 Suppl 1):35-41.
Traditionally, phosphate binders containing aluminum have been used effectively to control serum phosphorus levels in patients with chronic renal failure. In these patients, however, absorption and accumulation of aluminum in plasma and tissues can lead to debilitating pathologic conditions, including aluminum-related osteodystrophy. An alternative therapeutic approach using calcium carbonate as a phosphate binder has been proven to be effective. In a recent study of 20 patients on chronic hemodialysis, the efficacy of calcium carbonate therapy was demonstrated. Serum phosphorus levels in these patients were 4.8 +/- 0.13 mg/dL with the use of aluminum-containing phosphate binders, 7.3 +/- 0.26 mg/dL when phosphate binders were discontinued, and 4.8 +/- 0.17 mg/dL with the use of calcium carbonate (Os-CaL 500) therapy. The total amount of aluminum ingested for all 20 patients combined went from 112 g/d at the beginning of the study to 22 g/d at the end of the study. The amounts of calcium carbonate administered varied because of large variations in dietary phosphorus intake between patients. In addition, the individual distribution of phosphorus intake during the day dictated the dosing schedule. There were no adverse side effects associated with calcium carbonate therapy. A few patients ingesting large amounts of calcium carbonate to control their extremely high phosphorus levels developed hypercalcemia. However, this effect was reversible after discontinuation of calcium carbonate therapy.
传统上，含铝的磷结合剂已被有效地用于控制慢性肾衰竭患者的血清磷水平。然而，在这些患者中，铝在血浆和组织中的吸收与蓄积会导致使人衰弱的病理状况，包括铝相关性骨营养不良。一种使用碳酸钙作为磷结合剂的替代治疗方法已被证明是有效的。在最近一项针对20例慢性血液透析患者的研究中，证实了碳酸钙治疗的疗效。这些患者在使用含铝磷结合剂时血清磷水平为4.8±0.13mg/dL，停用磷结合剂时为7.3±0.26mg/dL，使用碳酸钙（Os-CaL 500）治疗时为4.8±0.17mg/dL。20例患者摄入铝的总量加在一起，从研究开始时的112g/d降至研究结束时的22g/d。由于患者之间饮食中磷摄入量差异很大，碳酸钙的给药量也有所不同。此外，一天中磷摄入量的个体分布决定了给药时间表。碳酸钙治疗未出现不良副作用。少数为控制极高磷水平而摄入大量碳酸钙的患者出现了高钙血症。然而，在停用碳酸钙治疗后，这种效应是可逆的。
