Spiegel D, Farmer B, Smits G, & Chonchol M. (2007). Magnesium carbonate is an effective phosphate binder for chronic hemodialysis patients: A Pilot Study. Journal of Renal Nutrition, 17(6), 216-422.
Magnesium carbonate is an effective phosphate binder for chronic hemodialysis patients: A Pilot Study.
Background
Combination phosphate binders are rarely used, however a few have been examined in the literature. Phosphate binders containing magnesium require additional monitoring of magnesium levels to prevent hypermagnesemia.
Trial Design
This was a prospective, randomized, open-label trial that lasted 3 months.
Population
Thirty hemodialysis patients were randomized in a 2:1 fashion to receive either a magnesium carbonate/calcium carbonate combination or calcium acetate phosphate binder after a 1-2 week washout phase.
Intervention/Comparator
Magnesium carbonate (86 mg of elemental magnesium) and calcium carbonate (100 mg of elemental calcium) were in the combination tablet. This tablet was compared to calcium acetate (previous binder dose).
Primary and Secondary Outcomes
The efficacy of a magnesium carbonate/calcium carbonate combination tablet as a phosphate binder. The goal was to maintain serum phosphorus within the KDOQI guidelines (<1.78 mmol/L).
Results
Both treatment options provided equivalent control of serum phosphorus within the KDOQI guidelines (70.6% combination vs 62.5 % calcium acetate; p value =ns). Serum magnesium levels were significantly higher in the combination arm with a mean serum level of 1.2 mmol/L (standard error mean, 1.1-1.3 mmol/L) compared to the calcium acetate arm with a mean serum level of 0.93 mmol/L (standard error mean, 0.90 – 0.98 mmol/L).
Limitations
Limitations include it was a non-blinded, single-center study with a small sample size and short in duration. Due to lack of follow-up there is insufficient long-term data on safety and efficacy with this phosphate binder.
Bottom Line
The magnesium carbonate/ calcium carbonate phosphate binder was equally as efficacious as calcium carbonate in controlling serum phosphate.
Magnesium carbonate is an effective phosphate binder for chronic hemodialysis patients: A Pilot Study.
Background
Combination phosphate binders are rarely used, however a few have been examined in the literature. Phosphate binders containing magnesium require additional monitoring of magnesium levels to prevent hypermagnesemia.
Trial Design
This was a prospective, randomized, open-label trial that lasted 3 months.
Population
Thirty hemodialysis patients were randomized in a 2:1 fashion to receive either a magnesium carbonate/calcium carbonate combination or calcium acetate phosphate binder after a 1-2 week washout phase.
Intervention/Comparator
Magnesium carbonate (86 mg of elemental magnesium) and calcium carbonate (100 mg of elemental calcium) were in the combination tablet. This tablet was compared to calcium acetate (previous binder dose).
Primary and Secondary Outcomes
The efficacy of a magnesium carbonate/calcium carbonate combination tablet as a phosphate binder. The goal was to maintain serum phosphorus within the KDOQI guidelines (<1.78 mmol/L).
Results
Both treatment options provided equivalent control of serum phosphorus within the KDOQI guidelines (70.6% combination vs 62.5 % calcium acetate; p value =ns). Serum magnesium levels were significantly higher in the combination arm with a mean serum level of 1.2 mmol/L (standard error mean, 1.1-1.3 mmol/L) compared to the calcium acetate arm with a mean serum level of 0.93 mmol/L (standard error mean, 0.90 – 0.98 mmol/L).
Limitations
Limitations include it was a non-blinded, single-center study with a small sample size and short in duration. Due to lack of follow-up there is insufficient long-term data on safety and efficacy with this phosphate binder.
Bottom Line
The magnesium carbonate/ calcium carbonate phosphate binder was equally as efficacious as calcium carbonate in controlling serum phosphate.