CALCIUM ACETATE - A GOOD ALTERNATIVE TO CALCIUM-CARBONATE FOR TREATING HYPERPHOSPHOREMIA IN CHRONIC-HEMODIALYSIS PATIENTS WITH HIGH-RISK OFHYPERCALCEMIA

The reintroduction of calcium compounds for the treatment of hyperphos phoremia has prevented aluminum complications, but patients treated wi th these calcium-compounds have a high risk of hypercalcemia, mainly t hose with severe hyperparathyroidism needing high doses of calcitriol. These risk of hypercalcemia has also been described in patients with low bone turnover. A review of the literature seems to assess that cal cium acetate produces less hypercalcemia than calcium carbonate. The a im of our study is to compare the efficacy of calcium acetate versus c alcium carbonate in order to control hyperphosphoremia, in patients on long-term hemodialysis therapy with hypercalcemia and different degre es of secondary hyperparathyroidism. We have studied 24 patients with serum calcium levels between 2.6 and 2.9 mmol/l randomly distributed i n 2 groups. One group maintained the same doses of calcium carbonate t han before and the second group was transfered to equivalent doses of calcium acetate. Serum calcium, phosphorus and i-PTH were measured in all patients at the beggining of the study and 3 months later. They we re no significant differences in i-PTH levels. Calcium and phosphorus decreased significantly in patients receiving calcium acetate and rema ined unchanged in the calcium carbonate group. From these data we agre e with other autors that calcium acetate could be the first choice for the treatment of hyperphosphoremia, in patients on long term hemodial ysis theraphy and high risk of hypercalcemia.