Calcium Carbonate versus Sevelamer Hydrochloride as Phosphate Binders after Long-Term Disease Progression in 5/6 Nephrectomized Rats
Törmänen, Suvi; Eräranta, Arttu; Riutta, Asko; Kööbi, Peeter; Honkanen, Teemu; Karavalakis, Emmanouil; Niemelä, Onni; Tokola, Heikki; Ruskoaho, Heikki; Mustonen, Jukka; Pörsti, Ilkka (2014)
Törmänen, Suvi
Eräranta, Arttu
Riutta, Asko
Kööbi, Peeter
Honkanen, Teemu
Karavalakis, Emmanouil
Niemelä, Onni
Tokola, Heikki
Ruskoaho, Heikki
Mustonen, Jukka
Pörsti, Ilkka
2014
Advances in Nephrology 2014 -
538392
Lääketieteen yksikkö - School of Medicine
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:uta-201607192092
https://urn.fi/URN:NBN:fi:uta-201607192092
Kuvaus
Copyright © 2014 Suvi Törmänen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Tiivistelmä
Our aim was to compare the effects of calcium carbonate and sevelamer-HCl treatments on calcium-phosphate metabolism and renal function in 5/6 nephrectomized (NX) rats so that long-term disease progression preceded the treatment. After 15-week progression, calcium carbonate (3.0%), sevelamer-HCl (3.0%), or control diets (0.3% calcium) were given for 9 weeks. Subtotal nephrectomy reduced creatinine clearance (−40%), plasma calcidiol (−25%), and calcitriol (−70%) and increased phosphate (+37%), parathyroid hormone (PTH) (11-fold), and fibroblast growth factor-23 (FGF-23) (4-fold). In NX rats, calcium carbonate diet increased plasma (+20%) and urinary calcium (6-fold), reduced plasma phosphate (−50%) and calcidiol (−30%), decreased creatinine clearance (−35%) and FGF 23 (−85%), and suppressed PTH without influencing blood pH. In NX rats, sevelamer-HCl increased urinary calcium (4-fold) and decreased creatinine clearance (−45%), PTH (−75%), blood pH (by 0.20 units), plasma calcidiol (−40%), and calcitriol (−65%). Plasma phosphate and FGF-23 were unchanged. In conclusion, when initiated after long-term progression of experimental renal insufficiency, calcium carbonate diet reduced plasma phosphate and FGF-23 while sevelamer-HCl did not. The former induced hypercalcemia, the latter induced acidosis, while both treatments reduced vitamin D metabolites and deteriorated renal function.Thus, delayed initiation influences the effects of these phosphate binders in remnant kidney rats.
Kokoelmat
- Artikkelit [6140]