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        "resumen" => "The rate of oxalate absorbed from intestine is highly influenced by calcium intake in healthy subjects. It is unknown whether commonly used phosphate binders modify intestinal absorption and renal excretion of oxalate in chronic kidney disease (CKD) patients. This study aims to determine if calcium carbonate or sevelamer influences on urinary oxalate excretion. Twenty patients with CKD (stage 4 and 5 pre-dialysis) were included. Two treatment (1500 mg of calcium carbonate or 2400 mg of sevelamer), two-period (21 days each), crossover study with balanced assignment of the order of administration, and two washout periods were the main characteristics of this study design. Laboratory analyses in each phase included: serum creatinine, calcium, phosphorus, bicarbonate, total cholesterol, and 24 h urinary excretion of oxalate, creatinine, and urea. Creatinine clearance, protein catabolic rate (PNNA), total urinary oxalate excretion, and urinary oxalate / creatinine ratio were determined. Seventeen patients completed both treatment sequences. Total urinary oxalate excretion and urinary oxalate / creatinine ratios decreased significantly with respect to washout periods either after sevelamer or calcium carbonate treatment. The decrease in urinary oxalate excretion was greater after calcium carbonate (41.2±17.4%) than after sevelamer treatment (30.4±23.8%). There were not significant changes in renal function or PNNA values throughout the study periods. In conclusion, either calcium carbonate or sevelamer significantly reduces urinary oxalate excretion in CKD patients. Further studies will be needed to ascertain whether the type of phosphate binder influences on the accumulation of oxalate in CKD patients. "
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        "resumen" => "El ácido oxálico (Ox) es una reconocida tóxina urémica. La cantidad de calcio en la dieta influye en la absorción intestinal de Ox en los sujetos sanos. Se desconoce si los quelantes de fósforo que contienen calcio o los nuevos quelantes sin calcio modifican la absorción o excreción de Ox en la enfermedad renal crónica (ERC). El objetivo de este estudio fue determinar si el carbonato cálcico (CC) o el sevelamer (S) modifican la excreción urinaria de oxalato en pacientes con ERC. Se incluyeron 20 pacientes con ERC estadios 4-5 pre-diálisis sin historia previa de litiasis o enfermedades digestivas. Tras un periodo de lavado sin quelantes se asignó a cada mitad del grupo la administración de CC 1500 mg ó S 2400 mg durante 21 días. Tras otro nuevo periodo de lavado (15 días), cada paciente recibió el tratamiento contrario durante otros 21 días. En cada fase del estudio se determinaron los siguientes parámetros séricos: creatinina, calcio, fósforo, bicarbonato, colesterol total. En orina recogida durante 24 horas se midió Ox, creatinina y urea, determinando la excreción total de oxalato, cociente Ox/creatinina, aclaramiento creatinina y tasa de catabolismo proteico. Diecisiete pacientes completaron el estudio. La administración tanto de CC como de S redujeron significativamente la excreción total de Ox y el cociente Ox / creatinina con respecto a las concentraciones en fases de lavado. La reducción de oxalato en orina fue mayor tras CC (41.2±17.4%) que tras S (30.4±23.8%), aunque estas diferencias entre quelantes no fueron estadísticamente significativas. El resto de los cambios bioquímicos observados fueron los esperables para cada uno de estos quelantes, sin que se observaran diferencias significativas ni en la función renal ni en la tasa de catabolismo proteico. En conclusión, tanto el CC como el S reducen la excreción urinaria de Ox en pacientes con ERC. Estos cambios son probablemente el reflejo de una menor absorción intestinal de Ox. El tipo de quelante de fósforo podría influir en la cantidad de Ox acumulado a lo largo de la evolución de la ERC. "
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Either calcium carbonate or sevelamer decreases urinary oxalate excretion in chronic renal failure patients
Carbonato cálcico o sevelamer reducen la excreción urinaria de oxalato en pacientes con insuficiencia renal avanzada
Francisco Caravaca, Ana Belén Ruiz, Jose María Escola, Román Hernández-Gallego, Isis Cerezo, Noemí Fernández, Sergio Barroso, María Vic
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        "resumen" => "The rate of oxalate absorbed from intestine is highly influenced by calcium intake in healthy subjects. It is unknown whether commonly used phosphate binders modify intestinal absorption and renal excretion of oxalate in chronic kidney disease (CKD) patients. This study aims to determine if calcium carbonate or sevelamer influences on urinary oxalate excretion. Twenty patients with CKD (stage 4 and 5 pre-dialysis) were included. Two treatment (1500 mg of calcium carbonate or 2400 mg of sevelamer), two-period (21 days each), crossover study with balanced assignment of the order of administration, and two washout periods were the main characteristics of this study design. Laboratory analyses in each phase included: serum creatinine, calcium, phosphorus, bicarbonate, total cholesterol, and 24 h urinary excretion of oxalate, creatinine, and urea. Creatinine clearance, protein catabolic rate (PNNA), total urinary oxalate excretion, and urinary oxalate / creatinine ratio were determined. Seventeen patients completed both treatment sequences. Total urinary oxalate excretion and urinary oxalate / creatinine ratios decreased significantly with respect to washout periods either after sevelamer or calcium carbonate treatment. The decrease in urinary oxalate excretion was greater after calcium carbonate (41.2±17.4%) than after sevelamer treatment (30.4±23.8%). There were not significant changes in renal function or PNNA values throughout the study periods. In conclusion, either calcium carbonate or sevelamer significantly reduces urinary oxalate excretion in CKD patients. Further studies will be needed to ascertain whether the type of phosphate binder influences on the accumulation of oxalate in CKD patients. "
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        "resumen" => "El ácido oxálico (Ox) es una reconocida tóxina urémica. La cantidad de calcio en la dieta influye en la absorción intestinal de Ox en los sujetos sanos. Se desconoce si los quelantes de fósforo que contienen calcio o los nuevos quelantes sin calcio modifican la absorción o excreción de Ox en la enfermedad renal crónica (ERC). El objetivo de este estudio fue determinar si el carbonato cálcico (CC) o el sevelamer (S) modifican la excreción urinaria de oxalato en pacientes con ERC. Se incluyeron 20 pacientes con ERC estadios 4-5 pre-diálisis sin historia previa de litiasis o enfermedades digestivas. Tras un periodo de lavado sin quelantes se asignó a cada mitad del grupo la administración de CC 1500 mg ó S 2400 mg durante 21 días. Tras otro nuevo periodo de lavado (15 días), cada paciente recibió el tratamiento contrario durante otros 21 días. En cada fase del estudio se determinaron los siguientes parámetros séricos: creatinina, calcio, fósforo, bicarbonato, colesterol total. En orina recogida durante 24 horas se midió Ox, creatinina y urea, determinando la excreción total de oxalato, cociente Ox/creatinina, aclaramiento creatinina y tasa de catabolismo proteico. Diecisiete pacientes completaron el estudio. La administración tanto de CC como de S redujeron significativamente la excreción total de Ox y el cociente Ox / creatinina con respecto a las concentraciones en fases de lavado. La reducción de oxalato en orina fue mayor tras CC (41.2±17.4%) que tras S (30.4±23.8%), aunque estas diferencias entre quelantes no fueron estadísticamente significativas. El resto de los cambios bioquímicos observados fueron los esperables para cada uno de estos quelantes, sin que se observaran diferencias significativas ni en la función renal ni en la tasa de catabolismo proteico. En conclusión, tanto el CC como el S reducen la excreción urinaria de Ox en pacientes con ERC. Estos cambios son probablemente el reflejo de una menor absorción intestinal de Ox. El tipo de quelante de fósforo podría influir en la cantidad de Ox acumulado a lo largo de la evolución de la ERC. "
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Article information
ISSN: 20132514
Original language: English
DOI:
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