Calcium-alpha-ketoglutarate (Ca-AKG) is known as a highly effective phosphate (P) binder in hemodialysis (HD) patients.
In addition, alpha-ketoglutarate has been shown to improve metabolic alterations. We investigated the effect of long-term P-binding therapy with Ca-AKG to determine whether P accumulation is the main reason of secondary hyperparathyroidism (HPT) in HD patients or not.
Ca-AKG was prescribed to 14 HD patients as a soluble preparation in a mean dosage of 4.5 g/day (0.975 g elemental Ca) for a period of 36 months. Serum P continuously dropped from prestudy 2.6 +/- 0.1 (mean +/- SEM) to 1.9 +/- 0.07 mmol/l (p < 0.001), whereas serum Ca increased from 2.2 +/- 0.1 to 2.47 +/- 0.08 mmol/l (p < 0.05). Thus, Ca/P ratio in serum converted significantly from 0.91 +/- 0.02 (prestudy) to 1.28 +/- 0.01 (p < 0.001).
Intact parathyroid hormone (iPTH) continuously normalized in all patients from 29 +/- 5 to 8 +/- 2 pmol/l (p < 0.001). The present data show that long-term treatment with 100% pure Calcium Alpha Ketoglutarate normalizes secondary HPT by simultaneously P binding and correcting Ca/P ratio in serum without vitamin D treatment.
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