Impact of Oral Calcium on Mortality of Dialysis Patients
Impact of Oral Calcium on Mortality of Dialysis Patients
Although the currently available evidence in dialysed patients is limited because only one study showed a direct effect of phosphate lowering on mortality and this only after a delay of 2 years; a second 5-year study—based on an admittedly low number of patients—nevertheless also suggested that the use of calcium-free phosphate binders is preferable to calcium-containing phosphate binders. The only uncontroversial evidence has recently been provided in patients with pre-terminal CKD.
In such patients, the use of calcium-free P binders is preferable over calcium-containing P binders. Because first class evidence is currently not yet available, the decision to use calcium-free phosphate binders should be based on the individual risk profile of a given patients.
Conclusion
Although the currently available evidence in dialysed patients is limited because only one study showed a direct effect of phosphate lowering on mortality and this only after a delay of 2 years; a second 5-year study—based on an admittedly low number of patients—nevertheless also suggested that the use of calcium-free phosphate binders is preferable to calcium-containing phosphate binders. The only uncontroversial evidence has recently been provided in patients with pre-terminal CKD.
In such patients, the use of calcium-free P binders is preferable over calcium-containing P binders. Because first class evidence is currently not yet available, the decision to use calcium-free phosphate binders should be based on the individual risk profile of a given patients.