| [ Summary ] |
Calcium (Ca) preparations, polymer preparations and lanthanum carbonate are commonly used phosphate binders. However, Ca preparations such as calcium carbonate may induce hypercalcemia and cause ectopic calcification with long-term use. In response to this concern, polymer preparations such as sevelamer hydrochloride were developed as non-Ca phosphate binders. On the other hand, these compounds commonly cause mild gastrointestinal side effects. Lanthanum carbonate is a similar non-Ca phosphate-binder. The effects of lanthanum accumulation in the body, in bone and other tissues, is a concern with long-term use. Several studies have shown that ferric compounds have phosphate-binding capacities and have potentials as phosphate binders. Ferric citrate, PA21, a stabilized poly-nuclear iron (III) oxyhydroxide and SBR759, a polymeric complex composed of iron (III) oxide and starch have serum P-reducing effects when used for hemodialysis and predialysis CKD patients. |