CAL-BAL

A randomised cross-over trial comparing the effects of two phosphate binders on calcium balance

Children with chronic kidney disease develop abnormalities in calcium and phosphate homeostasis. As kidney failure worsens, phosphate accumulates in the blood and calcium malabsorption leads to low blood calcium levels. The body attempts to compensate by increasing phosphate excretion and metabolic pathways are triggered that leach calcium out of the bones. This makes the bones soft and more prone to fracture. The growing bones of children are particularly vulnerable. To prevent and treat bone disease, chronic kidney disease patients are prescribed medicines called phosphate binders.

This cross-over trial will compare the calcium balance in 25 children when they are treated with a calcium-based phosphate-binder (calcium carbonate) and with a calcium-free phosphate-binder (sevelamer carbonate). Children will be treated with each type of binder for 3-month periods in a random order. Calcium balance will be measured using the natural calcium isotope ratio.

This trial is in set up.