Tier 2 — strong

Randomized crossover study comparing the phosphate-binding efficacy of calcium ketoglutarate versus calcium carbonate in patients on chronic hemodialysis

Bro S, Rasmussen RA, Handberg J, Olgaard K, Feldt-Rasmussen B
American Journal of Kidney Diseases 1998 31(2):257-262

Bibliography

PubMed
PMID 9469496
DOI
10.1053/ajkd.1998.v31.pm9469496
Funding
Funding information is not available in the PubMed record reviewed for this entry.
Competing interests
Competing-interest information is not reported in the PubMed record reviewed for this entry.

Study snapshot

DesignRandomized open crossover clinical trial.
ModelAdults on chronic hemodialysis.
Sample19 enrolled; 10 completed both treatment arms.
InterventionCalcium ketoglutarate granulate versus calcium carbonate, titrated for phosphate binding.
Duration12 weeks per treatment arm.
EndpointsPlasma ionized calcium; Plasma phosphate; PTH; Treatment tolerance; Gastrointestinal adverse effects

What the study showed, in plain terms

This randomized crossover study is particularly useful for Ca-AKG safety interpretation because it actively recorded tolerability.

Calcium ketoglutarate controlled phosphate similarly to calcium carbonate, but five of 17 exposed patients were withdrawn within one to two weeks because of anorexia, vomiting, diarrhea or general uneasiness. Those patients all had pre-existing gastrointestinal symptoms.

The finding should not be used to estimate adverse-event rates in healthy supplement users, but it is an important reminder that gram-level Ca-AKG is not universally well tolerated.

Key findings

  • Phosphate control was broadly comparable between calcium ketoglutarate and calcium carbonate.
  • Five of 17 exposed patients withdrew early because of gastrointestinal or general intolerance.
  • The intolerance cases clustered in patients with pre-existing gastrointestinal symptoms.

What this study can and cannot tell us

  • Renal-disease population and open-label design.
  • The intervention was being used as a phosphate binder rather than a longevity supplement.
  • The small sample produces an imprecise estimate of adverse-event frequency.

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