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Effect of Histamine H2-Receptor Antagonist on the Phosphorus-Binding Abilities of Calcium Carbonate and Calcium Lactate in Hemodialysis Patients

NORIHIRO TAKAHASHI^*, TETSUO SHOJI^*, KEISUKE MATSUBARA^*, HIROFUMI HITOMI^*, MAYUKO HASHIMOTO^*, HIDEYASU KIYOMOTO^*, KOICHI UCHIDA^*, SHIGEHIRO MIKI^*, MAMORU HIROHATA, TSUTOMU ISHIZU, KENJI AKIYAMA, KATSUFUMI MIZUSHIGE^*, HIROHIDE MATSUO^* and SHIGEKAZU YUASA^*

^* Second Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan.
Mitoyo General Hospital, Kagawa, Japan.

Correspondence to Dr. Norihiro Takahashi, Second Department of Internal Medicine, Kagawa Medical University, 1750-1, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan. Phone: 81 87 891 2150; Fax: 81 87 891 2152; E-mail: ntaka{at}kms.ac.jp

Abstract

Abstract. The effect of histamine H2-receptor antagonist (famotidine) on the phosphorus-binding abilities of calcium carbonate and calcium lactate were examined in 13 chronic hemodialysis patients. In seven patients receiving calcium carbonate, famotidine (20 mg/d) was given because of gastroduodenal disorders, and calcium carbonate was replaced with calcium lactate as a phosphorus binder after 4 wk of treatment with famotidine. With the 4-wk administration of famotidine accompanied by calcium carbonate, the serum phosphorus level increased from 6.3 ± 0.9 to 7.1 ± 0.5 mg/dl (P < 0.05). However, with the substitution of calcium lactate, the serum phosphorus level decreased significantly when compared to that before substitution (6.3 ± 0.2 and 6.0 ± 0.9 mg/dl after 4 and 8 wk of substitution, respectively), despite continued administration of famotidine. Serum calcium, creatinine, alkaline phosphatase, high sensitive parathyroid hormone, blood urea nitrogen, arterial blood pH, and bicarbonate were not significantly altered during the trial period. In six control patients treated with calcium carbonate alone, there were no statistical changes in serum calcium and phosphorus levels after substitution of calcium lactate for calcium carbonate. These results suggest that famotidine significantly affects the phosphorus-binding ability of calcium carbonate, but not that of calcium lactate. A careful observation of changes in the serum phosphorus level should be required in hemodialysis patients receiving calcium carbonate and histamine H2-receptor antagonists. Calcium lactate may be useful as a phosphorus binder in such hemodialysis patients.

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673