Influence of pH and phosphate concentration on the phosphate binding capacity of five contemporary binders. An in vitro study

Abstract IntroductionHyperphosphatemia is associated with increased mortality and morbidity in end stage renal disease. Despite phosphate binder therapy, a large proportion of patients does not reach the treatment target. In five contemporary binders we explored the influence of pH and phosphate concentration on phosphate binding. . This interaction could be of relevance in clinical practice. MethodsPhosphate binding was quantified in vitro in 25 ml of purified water containing phosphate concentrations of 10, 15 and 20 mM and baseline pH values of 3.0 or 6.0, with a binder over 6 hours. Lanthanum carbonate, calcium acetate/magnesium carbonate, sevelamer carbonate, calcium carbonate and sucroferric oxyhydroxide, 67 mg of each, were used. The experiments were performed in duplicate. The primary outcome was the difference in amount of bound phosphate for each binder after 6 hours in solutions at two different pH values. Secondary outcomes were the influence of phosphate concentration on phosphate binding, next to binding patterns and phosphatebinder saturation. Results and conclusionsIn this specific in vitro setting, lanthanum carbonate, sevelamer carbonate, calcium carbonate and sucroferric oxyhydroxide bound more phosphate in the solution with baseline pH of 3.0. Differences however were small except for lanthanum carbonate. Calcium acetate/magnesium carbonate was most effective in a solution with baseline pH of 6.0. All phosphate binders bound more phosphate in solutions wit...
Source: Nephrology - Category: Urology & Nephrology Authors: Tags: Original Article Source Type: research