Recent Canadian research supports KDIGO guidelines, suggesting that calcium-based phosphate binders used by CKD patients may be placing them at risk of cardiovascular disease and death. A systematic review of calcium usage among CKD patients published in Nephrology Dialysis Transplantation (NDT) found a strong trend suggesting an increased risk of death among patients taking calcium-based phosphate binders(5), signalling a potential safety issue related to the use of calcium-based phosphate binders.

"Although calcium-based phosphate binders are an effective compound in the treatment of CKD, they need to be prescribed in moderation so we can maintain an optimal mineral balance for patients rather than removing one mineral and loading them up with another," adds Dr. Mendelssohn. "As nephrologists, we need to consider guidelines and understand the ramifications of what we are prescribing to our patients."

"Bringing this issue to the attention of guideline decision-makers, through patients and physicians reporting all adverse side effects of calcium, will help to bridge the gap between the perceived benefits of calcium and the reality of its affect on those with CKD," says Dr. Sophie Jamal, director of the multidisciplinary osteoporosis program at Woman's College Hospital in Toronto and medical advisor to ImPACKD.

Education and empowerment are driving ImPACKD's efforts, emphasizing that patients should demand access to treatment alternatives and full information regarding risks and benefits of treatments from all health care professionals. "This vital information is necessary so people can make informed choices, but this is not the case with calcium overuse as it pertains to CKD," says Hugh O'Reilly, a Toronto lawyer with a special interest in patient advocacy. "Health Canada needs to provide guidance to the CKD community on its established calcium intake limit and clarify this as it relates to CKD patients. Lastly, safety issues need to be considered nation-wide by the provinces in order to provide access to the required treatment options for Canadians."

Source: GENZYME CANADA INC.