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NDT Advance Access originally published online on July 14, 2008
Nephrology Dialysis Transplantation 2008 23(10):3050-3052; doi:10.1093/ndt/gfn393
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Calcium-containing phosphate binders in dialysis patients with cardiovascular calcifications: should we CARE-2 avoid them?

Jürgen Floege

Division of Nephrology and Immunology, Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany

Jürgen Floege, Division of Nephrology, University Hospital, RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany. Tel: +49-241-8089-530; Fax: +49-241-8082-446; E-mail: juergen.floege@rwth-aachen.de

Keywords: calcification; calcium acetate; dialysis; phosphate binder; sevelamer

The first 10% of the full text of this article appears below.

Excess cardiovascular mortality is well documented in dialysis patients. Vascular calcifications, no matter where and how they are detected, are a potent predictor of mortality in such patients [1]. Many, albeit not all, studies have documented that an elevated serum calcium-phosphate product as well as the total dose of calcium-containing phosphate binders ingested correlates with the extent of vascular calcifications [2,3]. Thus, oral calcium loading might contribute to vascular calcification. This would be of particular importance in patients with serum parathyroid hormone levels <100 pg/ml, which usually indicates low-turnover bone disease [3], where the capacity of the bone to buffer calcium challenges is limited. Further evidence for a detrimental role of calcium loading is derived from the observation that the magnitude of intradialytic serum calcium increases predicts . . . [Full Text of this Article]



   Treat-to-goal study (TTG) [5]
 


   Renagel in new dialysis (RIND) patients’ study [6]
 


   Calcium acetate renagel evaluation (CARE-2) study [7]
 
A closer look at TTG versus CARE-2


   Conclusion
 

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