Efeect of histamirie H2-receptor antagonisits on the phosphorus-binding ability of phosphate binders in hemodialysis patients

Norihiro Takahashi, Shigekazu Yuasa, Hiroshi Hitomi, Mayuko Hashimoto, Hideyasu Kiyomoto, Koichi Uchida, Tetsuo Shoji, Mamoru Hirohata, Hirohide Matsuo

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

We examined the effects of histamine H2-receptor antagonists on the phosphorus binding ability of phosphate binders. Serum calcium, phosphorus, ALP, PTH and arterial blood pH and bicarbonate were measured during treatment with histamine H2-receptor antagonists accompanied by calcium carbonate in sixteen patients undergoing maintenance hemodialysis. Seven patients receiving histamine H2-receptor antagonists without calcium carbonate were selected as controls. In the sixteen patients receiving calcium carbonate, serum calcium, ALP, PTH and arterial blood pH and bicarbonate were not significantly altered during treatment with histamine H2-receptor antagonists, but serum phosphorus levels increased significantly after four (5.6 ± 1.1 mg/dl) and eight weeks (5.9 ± 0.8 mg/dl) of treatment as compared with that before treatment (4.8 ± 1.2 mg/dl). Furthermore, serum phosphorus Levels decreased significantly eight weeks after the discontinuation of treatment with histamine H2-receptor antagonists. In the seven control patients there were no statistical differences in serum calcium and phosphorus levels measered before and after treatment with histamine H2receptor antagonists. In seven other patients receiving histamine H2-receptor antagonists with calcium carbonate, calcium carbonate was replaced with calcium lactate as the phosphate binder after four weeks of treatment with histamine H2-receptor antagonists. With the 4-week administration of histamine H2-receptor antagonists accompanied by calcium carbonate, the serum phosphorus level increased, similarly to that of the first study (from 6.3 ± 0.9 to 7.1 ± 0.5 mg/dl). However, with the substitution of calcium lactate, the serum phosphorus level decreased significantly (6.3 ± 0.2 and 6.0 ± 0.9 mg/dl after four and eight weeks, respectively, despite continued administration of histamine H2-receptor antagonists). These results suggest that histamine H2-receptor antagonists significantly affect the phosphorus binding ability of calcium carbonate, but not of calcium lactate. Although the exact mechanism remains obscure, one possible explanation may be related to the rise in pH of the gastric juice. Careful observation of changes in the serum phosphorus level is required in hemodialysis patients receiving calcium carbonate and histamine H2-receptor antagonists. Calcium lactate may be useful as a phosphate binder in such hemodialysis patients.

Original languageEnglish
Pages (from-to)610-617
Number of pages8
JournalJapanese Journal of Nephrology
Volume38
Issue number12
Publication statusPublished - 1996 Dec 1

Keywords

  • Calcium carbonate
  • Calcium lactate
  • Hemodialysis
  • Histamine H-receptor antagonist
  • Hyperphosphatemia

ASJC Scopus subject areas

  • Nephrology

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