Phosphate Binders Do Not Interfere With Vitamin D Therapy

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In a study, mean 25-hydroxyvitamin D levels did not differ significantly among groups receiving phosphate binders or dietary therapy.
In a study, mean 25-hydroxyvitamin D levels did not differ significantly among groups receiving phosphate binders or dietary therapy.

AUSTIN, Texas—Despite concerns, phosphate binders do not appear to interfere with cholecalciferol therapy, Ivonne Lopez, MD, and colleagues from the University of the Texas Rio Grande Valley in Edinburg, Texas, reported at the National Kidney Foundation's 2018 Spring Clinical Meetings.

A total of 277 patients Hispanic hemodialysis patients had subpar serum 25-hydroxyvitamin D [25(OH)D] levels despite cholecalciferol supplementation. Of these, 54% received sevelamer and 19.6% received calcium acetate; 26.4% followed a low phosphorus diet alone.

Mean 25(OH)D levels did not differ significantly among the groups receiving phosphate binders vs a phosphorus-restricted diet: sevelamer carbonate 32.4 ng/mL vs calcium acetate 29.1 ng/mL vs dietary therapy 28 ng/mL. Nutritional status also did not explain vitamin D levels. In addition, 25(OH)D levels were similar whether participants had low (3.5 g/dL or less) or normal serum albumin: 28.6 vs. 31, respectively.

“Phosphate binders do not seem to chelate nor prevent absorption of cholecalciferol replacement therapy,” Dr Lopez and the team concluded.

Reference

Lopez I, Bui Y, Manllo S, Treviño S, and Mangoo-Karim R. Are low vitamin D levels in ESRD patients on hemodialysis a result of therapy with phosphate binders? Poster presented at the National Kidney Foundation's 2018 Spring Clinical Meetings in Austin, Texas, April 10-14, 2018.

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