Effect of histamine H2-receptor antagonist on the phosphorus-binding abilities of calcium carbonate and calcium lactate in hemodialysis patients

The effect of histamine H2-receptor antagonist (famotidine) on the phosphor us-binding abilities of calcium carbonate and calcium lactate were examined in 13 chronic hemodialysis patients. In seven patients receiving calcium c arbonate, famotidine (20 mg/d) was given because of gastroduodenal disorder s, and calcium carbonate was replaced with calcium lactate as a phosphorus binder after 4 wk of treatment with famotidine. With the 4-wk administratio n of famotidine accompanied by calcium carbonate, the serum phosphorus leve l increased from 6.3 +/- 0.9 to 7.1 +/- 0.5 mg/dl (P < 0.05). However, with the substitution of calcium lactate, the serum phosphorus level decreased significantly when compared to that before substitution (6.3 +/- 0.2 and 6. 0 +/- 0.9 mg/dl after 3 and 8 wk of substitution, respectively), despite co ntinued administration of famotidine. Serum calcium, creatinine, alkaline p hosphatase, high sensitive parathyroid hormone, blood urea nitrogen, arteri al blood pH. and bicarbonate were not significantly altered during the tria l period. In six control patients treated with calcium carbonate alone, the re were no statistical changes in serum calcium and phosphorus levels after substitution of calcium lactate for calcium carbonate. These results sugge st that famotidine significantly affects the phosphorus-binding ability of calcium carbonate, but not that of calcium lactate. A careful observation o f changes in the serum phosphorus level should be required in hemodialysis patients receiving calcium carbonate and histamine H2-receptor antagonists. Calcium lactate may be useful as a phosphorus binder in such hemodialysis patients.