Side Effects of calcium acetate: A Synthesis of Findings from 18 Studies

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Original Abstract of the Article

Major Research Findings

Calcium acetate is an effective phosphate binder used in the treatment of hyperphosphatemia in patients with chronic kidney disease. 17 14 15 3 6 A study comparing calcium acetate to calcium carbonate showed that calcium acetate was more effective at controlling serum phosphorus levels. 17 Calcium acetate was also found to be more effective at lowering phosphorus levels than calcium carbonate and had a lower risk of hypercalcemia. 14 A study investigating the effectiveness of iron-based phosphate binders found calcium acetate to be effective and have fewer side effects than conventional phosphate binders. 15 A review of phosphate binders for chronic kidney disease found that calcium acetate was as effective as sevelamer in reducing serum phosphorus with a similar safety profile and lower pill burden. 3 Calcium acetate/magnesium carbonate was found to be equally effective and safe as sevelamer in controlling serum phosphorus and calcium levels and resulted in lower costs. 6

Reasons for Side Effects

Side effects of calcium acetate are often due to calcium overload, which can lead to hypercalcemia, vascular calcification, and constipation. 17 10 11 12 13 14 3 6 2

Common Side Effects

Hypercalcemia

Calcium acetate has a high calcium content and therefore poses a risk of hypercalcemia. 17 14 3 6 Hypercalcemia can increase the risk of vascular calcification, heart disease, and kidney stones. 12

Vascular Calcification

Overconsumption of calcium acetate can increase the risk of vascular calcification. 11 Vascular calcification can increase the risk of heart disease, stroke, and peripheral artery disease. 12

Constipation

Calcium acetate can cause constipation. 10 Constipation can cause abdominal pain, bloating, and nausea. 11

Gastrointestinal Discomfort

Calcium acetate can cause gastrointestinal discomfort. 16 Gastrointestinal discomfort can cause nausea, vomiting, abdominal pain, and diarrhea. 3 6

Other Side Effects

Other side effects of calcium acetate include headache, dizziness, rash, and shortness of breath. 17

Side Effects Management

Hypercalcemia Management

Managing hypercalcemia includes adjusting the dose of calcium acetate and consuming foods low in calcium. 14 7 It may also be helpful to use drugs that inhibit calcium absorption. 3

Vascular Calcification Management

Managing vascular calcification includes treating hyperphosphatemia, hypertension, and diabetes to control risk factors. 11 Using calcium-free phosphate binders instead of calcium acetate can also be effective. 13 3

Constipation Management

Managing constipation includes consuming foods high in fiber and drinking plenty of fluids. 10 Constipation medication may be taken as needed. 11

Gastrointestinal Discomfort Management

Managing gastrointestinal discomfort includes taking calcium acetate with food and in smaller doses. 16 Antacids and digestive aids may be taken as needed.

Comparison Between Studies

Commonalities

Multiple studies have shown that calcium acetate is effective in treating hyperphosphatemia in patients with chronic kidney disease. 17 14 15 3 6 Calcium acetate can also cause side effects like hypercalcemia, vascular calcification, and constipation. 17 10 11 12 13 14 3 6

Differences

Studies comparing calcium acetate and calcium carbonate found calcium acetate to be more effective at controlling serum phosphorus levels. 17 14 Calcium acetate also had a lower risk of hypercalcemia than calcium carbonate. 14 A study investigating the effectiveness of iron-based phosphate binders found calcium acetate to be effective and have fewer side effects than conventional phosphate binders. 15 Calcium acetate was as effective as sevelamer in reducing serum phosphorus with a similar safety profile and lower pill burden. 3 Calcium acetate/magnesium carbonate was equally effective and safe as sevelamer in controlling serum phosphorus and calcium levels and resulted in lower costs. 6

Real-Life Application Considerations

While calcium acetate is an effective treatment for hyperphosphatemia in chronic kidney disease, it is important to be aware of the potential for side effects. 17 10 11 12 13 14 3 6 It is important to follow your doctor's instructions and take the correct dosage. 17 16 Consult your doctor immediately if you suspect any side effects. 17

Limitations of Current Research

There is a lack of sufficient research on the long-term effects and safety of calcium acetate. 17 15 There is also a lack of sufficient data on the side effects of calcium acetate. 10

Future Research Directions

Further research on the long-term effects and safety of calcium acetate is necessary. 17 15 More research is also needed on the side effects of calcium acetate. 10 Specifically, more research is needed on how to reduce the risk of vascular calcification. 11 12

Conclusion

Calcium acetate is an effective drug for treating hyperphosphatemia in patients with chronic kidney disease, but it's essential to understand the potential for side effects. 17 10 11 12 13 14 3 6 It's crucial to follow your doctor's directions and take the correct dosage. 17 16 Consult your doctor immediately if you suspect any side effects. 17

Literature analysis of 18 papers
Positive Content
16
Neutral Content
1
Negative Content
1
Article Type
3
0
0
8
17
3.

Phosphate binders for the treatment of chronic kidney disease: role of iron oxyhydroxide.

Author: CernaroValeria, SantoroDomenico, LacquanitiAntonio, CostantinoGiuseppe, ViscontiLuca, BuemiAntoine, BuemiMichele

Lower serum phosphate
Minimal iron absorption
Reduced pill burden
Calcifications
Gastrointestinal symptoms
Hypercalcemia
Tissue accumulation

This review discusses the use of sucroferric oxyhydroxide for treating hyperphosphatemia in patients with chronic kidney disease. Sucroferric oxyhydroxide has a similar efficacy and safety profile as sevelamer with a lower pill burden.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Design of cissus-alginate microbeads revealing mucoprotection properties in anti-inflammatory therapy.

Author: OkunlolaAdenike, OdekuOluwatoyin A, LamprechtAlf, OyagbemiAdemola A, OridupaOlayinka A, AinaOluwasanmi O

Anti-inflammatory treatment
Reduced gastric side effects

This study investigated the mucoprotective properties of cissus gum in the formulation of diclofenac microbeads for anti-inflammatory therapy in rats with carrageenan-induced paw edema. The results suggest that cissus gum could be suitable as a polymer in the formulation of non-steroidal anti-inflammatory drugs, ensuring sustained release while reducing gastric side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

1alpha(OH)D3 One-alpha-hydroxy-cholecalciferol--an active vitamin D analog. Clinical studies on prophylaxis and treatment of secondary hyperparathyroidism in uremic patients on chronic dialysis.

Author: BrandiLisbet

Secondary hyperparathyroidism treatment
Adynamic bone disease
Hypercalcemia

Chronic uremia is characterized by decreased plasma 1,25(OH)2D3 levels due to reduced renal 1-hydroxylase activity and decreased renal phosphate excretion. This leads to secondary hyperparathyroidism due to low plasma calcium and 1,25(OH)2D3 levels and high phosphate levels. Secondary hyperparathyroidism is linked to increased mortality and cardiovascular calcifications in chronic uremic patients. Treatment focuses on preventing hyperphosphatemia with oral phosphate binders and replacing the reduced renal hydroxylation with 1 alpha-hydroxylated vitamin D analogs. This thesis explores the effects of 1alpha(OH)D3 treatment in chronic dialysis patients, focusing on its ability to suppress plasma PTH levels without causing hypercalcemia. The study found that intravenous administration of 1alpha(OH)D3 effectively suppressed plasma PTH levels in patients on chronic hemodialysis without causing serious side effects, and hypercalcemia could be prevented by monitoring plasma Ca 2+ levels and adjusting 1alpha(OH)D3 doses accordingly. Long-term intermittent intravenous treatment with 1alpha(OH)D3 effectively suppressed plasma intact PTH levels. When plasma intact PTH was suppressed to a stable level with intravenous 1alpha(OH)D3, the suppression could be maintained by intermittent oral 1alpha(OH)D3 therapy. The study also investigated the effects of a treatment modality combining 1alpha(OH)D3 and CaCO3 as phosphate binders with reduced calcium concentration in dialysis fluid to prevent hypercalcemia. The combination prevented the development of secondary hyperparathyroidism in patients with normal PTH levels and suppressed PTH levels in patients with secondary hyperparathyroidism. No signs of adynamic bone disease were observed. Intravenous 1alpha(OH)D3 prevented bone mineral density (BMD) decrease in the lumbar spine and femoral neck of hemodialysis patients. The study also examined the pharmacokinetic differences between intravenous and oral administration of 1,25(OH)2D3 and 1alpha(OH)D3 and their acute effects on plasma PTH, Ca 2+, and phosphate levels.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Oral phosphate binders for the management of serum phosphate levels in dialysis patients.

Author: MohammedIsmail, HutchisonAlastair J

Cardiovascular mortality
Hypercalcemia
Vascular calcification

Hyperphosphatemia is a common consequence of end-stage chronic kidney disease and affects the majority of dialysis patients. It is statistically linked to increased cardiovascular mortality in this population. Dietary restriction and current dialysis modalities are not sufficiently effective to maintain serum phosphate levels within the recommended range, leading most dialysis patients to require oral phosphate binders. However, the benefits of achieving the recommended range have not been demonstrated prospectively. Traditional phosphate binders have limitations and side effects. Aluminium-containing agents, while highly efficient, are no longer widely used due to established toxicity. Calcium-based salts are inexpensive, effective, and most widely used but are now associated with hypercalcemia and vascular calcification. Sevelamer hydrochloride and lanthanum carbonate, non-aluminum, calcium-free phosphate binders, are effective and generally well-tolerated but do not control phosphate levels in all patients. Patient education programs have been shown to be effective in improving serum phosphate target achievement.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Amphipathic weak acid glucocorticoid prodrugs remote-loaded into sterically stabilized nanoliposomes evaluated in arthritic rats and in a Beagle dog: a novel approach to treating autoimmune arthritis.

Author: AvnirYuval, UlmanskyRina, WassermanVeronica, Even-ChenSimcha, BroyerMaya, BarenholzYechezkel, NaparstekYaakov

Rheumatoid arthritis treatment

This study investigated a novel approach to overcome the limitations of liposomal glucocorticoid formulations for rheumatoid arthritis. The limitations include low drug:lipid ratio, low encapsulation efficiency, and lack of controlled release.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

[Pharmacologic intervention for vascular calcification].

Author: SegawaHiroko, FurutaniJunya, MiyamotoKen-ichi

Prevention of vascular calcification
Constipation
Hypocalcaemia
Toxicity

Phosphate retention is a problem in dialysis patients that can lead to vascular calcification. This study highlights the need for new drugs to treat hyperphosphatemia that have fewer side effects and better compliance than existing phosphate binders.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Japanese

11.

Phosphate binder usage in kidney failure patients.

Author: BleyerAnthony J

Bind phosphorus
Vascular calcification

This article discusses the use of phosphorus binders in patients with kidney failure. It highlights the evolution of phosphorus binder therapy, from aluminium-based binders to calcium-containing binders, and then to newer alternatives such as sevelamer.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Management of disturbances of calcium and phosphate metabolism in chronic renal insufficiency, with emphasis on the control of hyperphosphataemia.

Author: LocatelliFrancesco, Cannata-AndíaJorge B, DrüekeTilman B, HörlWalter H, FouqueDenis, HeimburgerOlof, RitzEberhard

Treat CRI
Atherosclerosis
Soft tissue calcification

Disturbances in calcium-phosphate (Ca-P) metabolism are common in chronic renal insufficiency (CRI) and contribute to both bone disease (renal osteodystrophy) and soft tissue calcification, increasing the risk of vascular calcification and atherosclerosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Calcium acetate versus calcium carbonate in the control of hyperphosphatemia in hemodialysis patients.

Author: d'Almeida FilhoE J, da CruzE A, HoetteM, RuzanyF, KeenL N, LugonJ R

Treat hyperphosphatemia
Hypercalcemia

Calcium acetate was found to be a good alternative to calcium carbonate in controlling hyperphosphatemia in hemodialysis patients. A crossover, randomized, double-blind study involving 23 patients showed that calcium acetate was more effective at lowering phosphorus levels while causing less hypercalcemia.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

15.

Phosphate binders on iron basis: a new perspective?

Author: HergesellO, RitzE

Reduced phosphate levels

Trivalent iron-containing compounds are promising as alternative phosphate binders for uremic patients on maintenance hemodialysis, with no side effects or short-term toxicity observed so far.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Efficacy and tolerance of three different calcium acetate formulations in hemodialysis patients.

Author: van den BerghJ P, GelensM A, KlaassenH A, KaufmannB G, BöttgerW M, VerstappenV M

Phosphate binding
Gastrointestinal discomfort

This study evaluated two new formulations of calcium acetate (CaAc), a phosphate binder used in patients with chronic renal failure. Neutral-coated and enteric-coated CaAc formulations were developed to address gastrointestinal discomfort, a common side effect of CaAc.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

17.

Calcium acetate versus calcium carbonate as phosphate binders in hemodialysis patients.

Author: CaravacaF, SantosI, CuberoJ J, EsparragoJ F, ArrobasM, PizarroJ L, RoblesR, Sanchez-CasadoE

Hemodialysis treatment
Calcium elevation
Poor tolerance

A study of 80 hemodialysis patients compared calcium acetate (CA) and calcium carbonate (CC) for controlling phosphorus levels. Both treatments effectively controlled phosphorus levels, but CA was poorly tolerated by more patients (7 vs. 2 for CC). CC was more effective in raising calcium levels. There was no difference in the control of parathyroid hormone or bicarbonate levels. The study suggests that CC may be a more effective and better-tolerated treatment option for managing phosphorus levels in hemodialysis patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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