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Metal-Binding Acetate Vs. Carbonate

Chronic kidney disease (CKD) affects more than 20 million Americans, according to the Cleveland Clinic website. Blood-pressure control is essential in the early stages of this irreversible five-stage disease to slow its progression. Typical clinical treatment plans address each stage of the disease, with calcium acetate or calcium carbonate binders being used in stages 2 through 5 to inhibit serum phosphorous levels to help control blood pressure. Calcium acetate generally is described as the more efficient of the two phosphate inhibitors.

  1. Calcium Acetate

    • The National Kidney Foundation has classified kidney disease as having five stages, starting with stage 1 kidney damage with normal urine output and ending with stage 5 end-stage renal disease (ESRD) requiring dialysis and kidney transplants. Calcium acetate, a mineral, is used in the treatment of kidney disease as a prescription medicine under the brand names PhosLo, Phoslyra, Eliphos and Calphron. Calcium acetate lowers too-high phosphorous levels in the blood, a condition known as phosphatemia. Lower phosphorous levels mean lower blood pressure, which slows the progress of chronic -- and incurable -- kidney disease. Calcium acetate removes dietary phosphorous from the blood by binding to it and restricting its absorption in the gut, after which it is excreted from the body in human waste.

    Calcium Carbonate

    • Calcium carbonate, a compound mineral containing calcium, carbon and oxygen, is a white, nontoxic, odorless solid that occurs in nature as chalk, limestone and marble. It is sold in over-the-counter brand name products like Caltrate, Calcitriol and Renagel. Like calcium actetate, when calcium carbonate is ingested it binds to dietary phosphorous, prevents its absorption and removes it from the blood in human waste. Research data from the National Kidney Foundation support reports that calcium acetate has a higher phosphorous-binding ability than calcium carbonate, which makes it a more effective phosphorous inhibitor in the treatment of kidney disease than calcium carbonate.

    Advantages

    • Calcium acetate not only helps slow the progress of kidney disease by lowering blood pressure and phosphorous levels, but it also protects the body from the bone damage of osteoporosis (brittle bones) and helps reduce the risk of heart disease and strokes. Calcium carbonate does not absorb as much phosphorous as calcium actetate (39 mg of phosphorous absorbed per 1 mg of calcium carbonate, compared to calcium acetate's absorption rate of 45 mg of phosphorous per 1 mg of calcium acetate), but it is a phosphorous inhibitor, is inexpensive, is readily available in many over-the-counter forms such as Caltrate, Tums and OsCal, and does not require a prescription.

    Disadvantages

    • Both calcium acetate and calcium carbonate run the risk of producing too much calcium in the blood (a condition known as hypercalcemia), dry mouth, extraskeletal calcifications and gastrointestinal side effects like constipation, nausea, abdominal pain and loss of appetite. In addition, pregnant women and nursing mothers should use either of these forms of calcium only when absolutely necessary and after consulting their physicians.

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