Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2008;40(1):193-201.
doi: 10.1007/s11255-007-9300-0. Epub 2008 Jan 10.

Magnesium carbonate for phosphate control in patients on hemodialysis. A randomized controlled trial

Ioannis P Tzanakis  1 , Antonia N Papadaki, Mingxin Wei, Stella Kagia, Vlassios V Spadidakis, Nikolaos E Kallivretakis, Dimitrios G Oreopoulos
Affiliations
Randomized Controlled Trial

Magnesium carbonate for phosphate control in patients on hemodialysis. A randomized controlled trial

Ioannis P Tzanakis et al. Int Urol Nephrol. 2008.

Abstract

Background: Magnesium salts bind dietary phosphorus, but their use in renal patients is limited due to their potential for causing side effects. The aim of this study was to evaluate the efficacy and safety of magnesium carbonate (MgCO(3)) as a phosphate-binder in hemodialysis patients.

Methods: Forty-six stable hemodialysis patients were randomly allocated to receive either MgCO(3) (n=25) or calcium carbonate (CaCO(3)), (n=21) for 6 months. The concentration of Mg in the dialysate bath was 0.30 mmol/l in the MgCO(3) group and 0.48 mmol/l in the CaCO(3) group.

Results: Only two of 25 patients (8%) discontinued ingestion of MgCO(3) due to complications: one (4%) because of persistent diarrhea, and the other (4%) because of recurrent hypermagnesemia. In the MgCO(3) and CaCO(3) groups, respectively, time-averaged (months 1-6) serum concentrations were: phosphate (P), 5.47 vs. 5.29 mg/dl, P=ns; Ca, 9.13 vs. 9.60 mg/dl, P<0.001; Ca x P product, 50.35 vs. 50.70 (mg/dl)(2), P=ns; Mg, 2.57 vs. 2.41 mg/dl, P=ns; intact parathyroid hormone (iPTH), 285 vs. 235 pg/ml, P<0.01. At month 6, iPTH levels did not differ between groups: 251 vs. 212 pg/ml, P=ns. At month 6 the percentages of patients with serum levels of phosphate, Ca x P product and iPTH that fell within the Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines were similar in both groups, whereas more patients in the MgCO(3) group (17/23; 73.91%) than in the CaCO(3) group (5/20, 25%) had serum Ca levels that fell within these guidelines, with the difference being significant at P<0.01.

Conclusion: Our study shows that MgCO(3) administered for a period of 6 months is an effective and inexpensive agent to control serum phosphate levels in hemodialysis patients. The administration of MgCO(3) in combination with a low dialysate Mg concentration avoids the risk of severe hypermagnesemia.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Monthly follow-up of serum phosphate (sP)
Fig. 2
Fig. 2
Monthly follow-up of serum calcium (sCa)
Fig. 3
Fig. 3
Monthly follow-up of serum Ca × P product (SCa × P)
Fig. 4
Fig. 4
Monthly follow-up of serum PTH (siPTH)
See this image and copyright information in PMC

References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1097/01.ASN.0000133041.27682.A2', 'is_inner': False, 'url': 'https://doi.org/10.1097/01.asn.0000133041.27682.a2'}, {'type': 'PubMed', 'value': '15284307', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15284307/'}]}
    2. Block GA, Klassen PS, Lazarus JM, Ofsthum N, Lowrie EG, Chertow GM (2004) Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol 15:2208–2218 - PubMed
    1. Drueke T, Foley RN (2006) Improving outcomes in chronic kidney disease. Kidney Int Suppl 105:S1–S4 - PubMed
    1. Salusky IB (2006) A new era in phosphate binder therapy. What are the options? Kidney Int Suppl 105:S10–S15 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '2870354', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/2870354/'}]}
    2. O’Donovan R, Baldwin D, Hammer M, Moniz C, Parsons V (1980) Substitution of aluminium salts by magnesium salts in control of dialysis hyperphosphatemia. Lancet 1:880–882 - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1038/ki.1996.22', 'is_inner': False, 'url': 'https://doi.org/10.1038/ki.1996.22'}, {'type': 'PubMed', 'value': '8770963', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/8770963/'}]}
    2. Delmez JA, Kelber J, Norword KY, Slatopolsky E (1996) Magnesium carbonate as a phosphate binder: a prospective, controlled, crossover study. Kidney Int 49:163–167 - PubMed

Publication types