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      The Use of Magnesium-Containing Phosphate Binders in Patients with End-Stage Renal Disease on Maintenance Hemodialysis

      , , ,

      Nephron

      S. Karger AG

      Magnesium, Hemodialysis, Phosphate binders

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          Abstract

          We investigated the safety and efficacy of magnesium hydroxide as a phosphate binder in patients with end-stage renal disease on maintenance hemodialysis. 9 volunteers participated in a four-phase study during which each ingested (1) no phosphate binders, (2) magnesium hydroxide (Mg(OH)<sub>2</sub>) alone, (3) Mg(OH)<sub>2</sub> and aluminum hydroxide (Al (OH)<sub>3</sub>) together and (4) Al(OH)<sub>3</sub> alone. Serum magnesium (SMg) concentrations were maintained at less than 4.5 mEq/l (2.3 mmol/l) in all subjects while they were ingesting 0.75–3 g Mg(OH)<sub>2</sub>/day and no magnesium toxicity was noted. In individuals taking a constant daily dose, SMg remained stable over 8–12 weeks. Serum phosphorus (SP) decreased from 9.0 mg/dl (2.9 mmol/l) during the control period to 8.1 mg/dl (2.6 mmol/l) during the Mg(OH)<sub>2</sub> period (p < 0.05) and increased from 6.1 mg/dl (2.0 mmol/l) during the Mg(OH)<sub>2</sub> and Al(OH)<sub>3</sub> period to 7.0 mg/dl (2.3 mmol/l) during the Al(OH)<sub>3</sub> period (p < 0.05) indicating that Mg(OH)<sub>2</sub> could significantly lower SP. However, SP was best controlled (6.1 mg/dl; 2.0 mmol/l) when Al(OH)<sub>3</sub> and Mg(OH > 2 were used together and all participants preferred the combination therapy to either of the agents alone. These results indicate that Mg(OH)<sub>2</sub> is a potentially useful adjunct to Al(OH)<sub>3</sub> for managing hyperphosphatemia in patients on maintenance hemodialysis. In this short-term study Mg(OH)<sub>2</sub> was well tolerated and with appropriate monitoring did not cause uncontrolled hypermagnesemia. Further studies are clearly required to determine whether long-term therapy with Mg-containing agents is safe in dialysis patients.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1982
          1982
          03 December 2008
          : 30
          : 2
          : 114-117
          Affiliations
          Department of Medicine, University of Vermont College of Medicine, Burlington, Vt., USA
          Article
          182446 Nephron 1982;30:114–117
          10.1159/000182446
          7099318
          © 1982 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 4
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Hemodialysis, Phosphate binders, Magnesium

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