The Medical Letter on Drugs and Therapeutics
FROM
ISSUE
1228
Phosphate Binders
Subscribers: Log in to read full article.  Not a subscriber?  Subscribe or purchase article.

Hyperphosphatemia in end-stage renal disease can lead to secondary hyperparathyroidism, renal osteodystrophy, metastatic calcification and cardiovascular mortality. In addition to dietary restriction of phosphorus and hemodialysis, drugs that bind phosphates in the gut are usually needed as well. Aluminum hydroxide is no longer recommended for long-term use because of concerns about its toxicity.1,2

CALCIUM CARBONATE — The usefulness of calcium carbonate (Os-Cal, and others) as a phosphate binder is limited by its insolubility at a high gastric pH, which is often present in end-stage renal disease. It can cause gastrointestinal (GI) discomfort and hypercalcemia, which could lead to arterial calcification and possibly cardiac death.3

CALCIUM ACETATE — Compared to calcium carbonate, the solubility and phosphate-binding capacity of calcium ... more      

The Medical Letter is a subscriber-funded nonprofit organization that publishes critical appraisals of new prescription drugs and comparative reviews of drugs for common diseases.

Would you like to read the rest of this article?  Gain access below.

Subscribe
Subscriptions to The Medical Letter on Drugs and Therapeutics include:
  • Print version published and mailed biweekly (26 issues/year)
  • Unlimited online access to current and past issues (1988 - present)
  • Mobile App for iOS, Android, and Kindle Fire
  • FREE online per issue CME/CE
Purchase this article:
Title: Phosphate Binders
Article code: 1228c
 Electronic, downloadable article - $45
Gain access through your organization
Ask your librarian to consider an Institutional Subscription to The Medical Letter.
Recommend to your librarian