Chewing Gum Aids Phosphate Control by ProQuest

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									32 Renal & Urology News          MARCH 2009                                                                            www.renalandurologynews.com




Chewing Gum Aids Phosphate Control
Binding salivary phosphate may be a useful adjunct to traditional phosphate binders in dialysis patients
ADDING SALIVARY phosphate-           about 50% of HD patients achieve        phate content is much higher than        phate during periods of fasting in ad-
binding chewing gum to traditional   serum phosphate levels recommend-       serum phosphate levels.                  dition to using phosphate binders
phosphate-binder therapy may im-     ed by the Kidney Disease Outcomes         In a new study, Vincenzo Savica, MD,   with meals could improve hyperphos-
prove hyperphosphatemia control in   Quality Initiative guidelines. Pre-     of the University of Messina, Lorenzo    phatemia treatment. Their study in-
hemodialysis (HD) patients.          vious research shows that salivary      A. Calò MD, PhD, of the University of    cluded 13 HD patients with serum
  Researchers noted that even with   phosphate levels correlate with serum   Padova, Italy, and colleagues tested a   phosphate levels above 6.0 mg/dL
the use of phosphate binders, only   phosphate although salivary phos-       hypothesis that binding salivary phos-   despite treatment with sevelamer
                                                                                                                      hydrochloride. The investigators tested
                                                                                                                      a newly formulated gum (CM&D
                                                                                                                      Pharma Ltd., UK) containing 20 mg
                                                                                                                      of chitosan, a natural polymer shown
                                                                                                                      to have phosphate-binding capabil-
                                                                                                                      ity. They instructed patients to chew
                                                                                                                      the gum between meals twice daily
                                                                                                                      for two weeks in addition to adhering
                                                                                                                      to their prescribed phosphorus-
                                                                                                                      restricted diet and regimen of seve-
                                                                                                                      lamer hydrochloride.
                                                                                                                        By the end of week 2, salivary phos-
                                                                                                                      phate decreased 55% from baseline
                                                                                                                      (from 73.21 to 33.19 mg/dL) and
                                                                                                                      serum phosphate decreased 31%


                                                                                                                      Chitosan, the active
                                                                                                                      ingredient, did not
                                                                                                                      affect parathyroid
                                                                                                                      hormone levels.
                                                                                                                      from baseline (7.6 to 5.25 mg/dL),
                                                                                    
								
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