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Calcium salts of keto-amino acids, a phosphate binder alternative for patients on CAPD.
Clin Nephrol. 1997 Sep; 48(3):181-4.CN

Abstract

Control of hyperphosphoremia is crucial to the prevention of secondary hyperparathyroidism. Calcium salts of keto-amino acids (KAA) were employed as phosphate binders in hemodialysis patients. We wanted to assess the efficacy of these substances as quelating agents in patients under continuous ambulatory peritoneal dialysis (CAPD). Also, as an amino acid supplement, we determined their possible effect on some parameters related to nutritional status. We studied 13 patients (7 M; 6 F) with a mean age of 45.2 +/- 17 years and a mean time on CAPD of 18.4 +/- 11.4 months. None had severe secondary hyperparathyroidism and/or clinically relevant aluminium intoxication. They were not receiving calcitriol and none were using low-calcium peritoneal dialysis fluids. All were under aluminum hydroxide (AlOH3) treatment and 8 patients also received calcium carbonate. These quelating agents were withdrawn and after 21 days (wash-out period) KAA were initiated. We analyzed serum levels of bone metabolism parameters (calcium, phosphate, osteocalcin [OC], intact parathyroid hormone [iPTH], alkaline phosphatase [AP]) and nutritional parameters (total protein, albumin, pre-albumin, transferrin) in four periods: (A) during AlOH3; (B) immediately after the washout period; (C) after 1.5 months; and (D) after 3 months of KAA therapy. In 5 patients serum aluminum level was also measured in periods (A) and (D). The serum phosphate level at period (B) was significantly higher than in other periods. After 3 months of treatment phosphate levels decreased significantly (A = 1.77 +/- 0.3 mmol/l vs D = 1.48 +/- 0.2; p < 0.05). Serum calcium levels increased, while iPTH and OC decreased (p = ns). AP remained stable during the study. All nutritional parameters increased at the end of the study (p = ns). Calcium salts of keto-amino acids showed to be an effective alternative to aluminum-containing phosphate binders. They were well tolerated, without relevant side-effects. These compounds could also represent an additional source of oral amino acid supplementation with improvement of nutritional status.

Authors+Show Affiliations

Department of Nephrology, Hospital Ntra. Sra. de Candelaria, Santa Cruz de Tenerife, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

9342490

Citation

Macia, M, et al. "Calcium Salts of Keto-amino Acids, a Phosphate Binder Alternative for Patients On CAPD." Clinical Nephrology, vol. 48, no. 3, 1997, pp. 181-4.
Macia M, Coronel F, Navarro JF, et al. Calcium salts of keto-amino acids, a phosphate binder alternative for patients on CAPD. Clin Nephrol. 1997;48(3):181-4.
Macia, M., Coronel, F., Navarro, J. F., Gallego, E., Herrero, J. A., Méndez, M. L., Chahin, J., & García, J. (1997). Calcium salts of keto-amino acids, a phosphate binder alternative for patients on CAPD. Clinical Nephrology, 48(3), 181-4.
Macia M, et al. Calcium Salts of Keto-amino Acids, a Phosphate Binder Alternative for Patients On CAPD. Clin Nephrol. 1997;48(3):181-4. PubMed PMID: 9342490.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calcium salts of keto-amino acids, a phosphate binder alternative for patients on CAPD. AU - Macia,M, AU - Coronel,F, AU - Navarro,J F, AU - Gallego,E, AU - Herrero,J A, AU - Méndez,M L, AU - Chahin,J, AU - García,J, PY - 1997/10/29/pubmed PY - 1997/10/29/medline PY - 1997/10/29/entrez SP - 181 EP - 4 JF - Clinical nephrology JO - Clin Nephrol VL - 48 IS - 3 N2 - Control of hyperphosphoremia is crucial to the prevention of secondary hyperparathyroidism. Calcium salts of keto-amino acids (KAA) were employed as phosphate binders in hemodialysis patients. We wanted to assess the efficacy of these substances as quelating agents in patients under continuous ambulatory peritoneal dialysis (CAPD). Also, as an amino acid supplement, we determined their possible effect on some parameters related to nutritional status. We studied 13 patients (7 M; 6 F) with a mean age of 45.2 +/- 17 years and a mean time on CAPD of 18.4 +/- 11.4 months. None had severe secondary hyperparathyroidism and/or clinically relevant aluminium intoxication. They were not receiving calcitriol and none were using low-calcium peritoneal dialysis fluids. All were under aluminum hydroxide (AlOH3) treatment and 8 patients also received calcium carbonate. These quelating agents were withdrawn and after 21 days (wash-out period) KAA were initiated. We analyzed serum levels of bone metabolism parameters (calcium, phosphate, osteocalcin [OC], intact parathyroid hormone [iPTH], alkaline phosphatase [AP]) and nutritional parameters (total protein, albumin, pre-albumin, transferrin) in four periods: (A) during AlOH3; (B) immediately after the washout period; (C) after 1.5 months; and (D) after 3 months of KAA therapy. In 5 patients serum aluminum level was also measured in periods (A) and (D). The serum phosphate level at period (B) was significantly higher than in other periods. After 3 months of treatment phosphate levels decreased significantly (A = 1.77 +/- 0.3 mmol/l vs D = 1.48 +/- 0.2; p < 0.05). Serum calcium levels increased, while iPTH and OC decreased (p = ns). AP remained stable during the study. All nutritional parameters increased at the end of the study (p = ns). Calcium salts of keto-amino acids showed to be an effective alternative to aluminum-containing phosphate binders. They were well tolerated, without relevant side-effects. These compounds could also represent an additional source of oral amino acid supplementation with improvement of nutritional status. SN - 0301-0430 UR - https://www.unboundmedicine.com/medline/citation/9342490/Calcium_salts_of_keto_amino_acids_a_phosphate_binder_alternative_for_patients_on_CAPD_ L2 - https://antibodies.cancer.gov/detail/CPTC-KRAS4B-1 DB - PRIME DP - Unbound Medicine ER -