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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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