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Red Flag for Chronic Kidney Disease Therapy Raised by Researchers

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A new research published in the journal The Lancet questions a common clinical practice performed on patients suffering from CKD (chronic kidney disease). This clinical practice involves the prescription of high doses of calcium. The research team, comprised of researchers from the University of Toronto and from the University of Alberta, in Canada, revealed that lower doses of calcium improved the heart condition of patients and also increased their survivability rate.

The lead author of the study is associate professor Sophie Jamal, from the Women’s College Hospital, while the senior author is professor Ross Tsuyuki, from the Faculty of Medicine & Dentistry, at the University of Alberta. According to the results of their study, survivability increased by approximately 22% when patients suffering from chronic kidney disease were given lower doses of calcium, instead of the usual high doses. Furthermore, patients who weren’t prescribed calcium showed improved coronary arteries health. More than 4,500 patients from 11 randomized clinical trials were involved in the study. Researchers also compared the subjects who received calcium to the patients who received other therapies, such as sevelamer and lanthanum. These therapies do not involve the use of calcium.

Patients suffering from chronic kidney disease are being prescribe calcium due to the impossibility of their kidney to excrete phosphate. This inability causes the levels of phosphate in the organism to rise, causing damage and other disorders. Calcium binds to phosphate and creates a compound that can be eliminated from the organism through urine. Both sevelamer and lanthanum can also remove the excess phosphate from the organism, but they cost more in comparison to calcium.

Professor Tsuyuki affirms that patients taking the non-calcium-based drugs are less susceptible to death and have healthier hearts. However, he adds that further investigations are needed in order to determine whether high levels of calcium are bad, or if the treatment with lanthanum or sevelamer is good. Tsuyuki says that many scientists and physicians have been advocating for the removal of calcium therapy for patients suffering from chronic kidney disease, adding that the current study adds more evidence towards removing calcium from chronic kidney disease therapy.

Sophie Jamal says that although physicians have been prescribing calcium supplements in order to stop the rise of phosphate levels, numerous studies have shown that these supplements can damage the heart and increase the prevalence of heart disease. She adds that the current study validates the results of previous research, showing that long-term treatment with calcium supplements has important medical consequences.

According to an editorial that accompanied the study article in the journal The Lancet, a question was raised, whether the results of the study could mean the “game will change”, meaning that the therapy plans for patients suffering from chronic kidney disease will be changed in the near future. Researchers say that due to the high calcium intake, heart disease has become the number one enemy for people suffering from chronic kidney disease.