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Author Topic: Phosphate Binders  (Read 29283 times)
angieskidney
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« Reply #50 on: August 05, 2006, 05:30:25 PM »

Hello all.  Renagel has worked well for me.  I take 4 800mg tabs with meals. 

Ya, and with the SIZE of those pills .. there is no way for me :( So I just take one 1000mg Tums and I am all set!

My bloodwork results: My Phosphate was PERFECT this month!!!!  ;D ;D ;D
« Last Edit: August 05, 2006, 08:37:00 PM by angieskidney » Logged

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« Reply #51 on: August 05, 2006, 07:38:57 PM »

I take Renagel myself.  Was on Phoslo but it raised my calcium levels way too high.

The ones that I hated swallowing were the old aluminum binders back in the day. :P
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kitkatz
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« Reply #52 on: August 05, 2006, 11:00:43 PM »

Nummy, yummy for the tummy fosrenol.  Like eating chalk, but I manage to choke it down after every meal if I remember it.  I am going to start puttping one in my lunch box everyday with lunch so I remember at work to take it.
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« Reply #53 on: August 06, 2006, 04:18:40 AM »

I don't think Tums is a binder.  Don't people take it for the calcium content?
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BigSky
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« Reply #54 on: August 06, 2006, 07:05:13 AM »

Some people are able to use TUMS as their binder.   

TUMS is calcium carbonate and PhosLo is calcium acetate. 

Drug companies say TUMS binding action isn't as great as their drugs are.  However it really depends on the patient.  Some can get away with it and some cannot. 








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« Reply #55 on: August 06, 2006, 08:14:05 AM »

For a short time, I used Tums only, and my labs showed some control of my phosphate/calcium situation.  This last month however, I was not so 'compliant' and I got a warning on Friday from my nephro.
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angieskidney
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« Reply #56 on: August 06, 2006, 05:42:52 PM »

I don't think Tums is a binder.  Don't people take it for the calcium content?
Yes, Tums can be taken as a phosphate binder as long as you can take the Calcium. I don't take additional calcium and my dietitian and Nephrologist said to take them so I do. I have been told how much and everything. So yes, it is definately used as a phosphate binder. I take 1000mg ones. I take up to 3 with each meal depending on what I am eating and how much.

Here is a link about it and which I quote from:

Quote
TumsŪ (calcium carbonate; Smith-Kline Beecham, Pittsburgh, PA) is primarily used as an antacid,3 but has been used as a source of calcium carbonate to bind phosphorus in hyperphosphatemia patients.
« Last Edit: August 06, 2006, 05:46:44 PM by angieskidney » Logged

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Zach
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« Reply #57 on: August 13, 2006, 05:38:30 AM »

Right now I'm using a combination of one Renagel for every two PhosLo -- instead of taking three PhosLo for meals with larger phosphorus loads.

In the past I've used TUMS EX. And in the old days, I took OSCAL and in the beginning there was Baselgel (Aluminum, very bad for us!).

I struggle with keeping my phosphorus down to about 5.5 mg/dL, while not raising my calcium above 10 mg/dL.  Last week the calcium was 10.8 and phosphorus was 4.9, the week before the calcium was 10.3 and phosphorus was 5.6   :-[

TUMS and PhosLo overtime raised my calcium, so I tried switching to Renagel, but it gave me indigestion and lowered my Carbon Dioxide level (CO2).  I'm now trying the combination.

I also just switched from IV Hectoral to IV Zemplar (to reduce PTH levels).  PTH medications can affect the gut's absorption of calcium.  We'll see what happens!
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
BigSky
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« Reply #58 on: August 13, 2006, 07:00:16 AM »


I also just switched from IV Hectoral to IV Zemplar (to reduce PTH levels).  PTH medications can affect the gut's absorption of calcium.  We'll see what happens!

Should see a drop.  My PTH was high so I was put on hectoral and my Calcium stayed the same, 8.5 but my phosphorus dropped from 3.5 down to 2.0.
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Zach
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« Reply #59 on: August 13, 2006, 07:32:12 AM »

Hey BigSky,

Those are some impressive numbers you've got!
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
MattyBoy100
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« Reply #60 on: August 24, 2006, 09:57:56 AM »

hi,

I have to take 3 Renegels before each meal.  I don`t worry about the cost of my drugs cos living in the UK and my illness being considered chronic and because I have a fistula, I get them for free from the National Health Service although this isn`t the case for every type of illness.
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« Reply #61 on: August 25, 2006, 05:57:05 AM »

Ian only has to take three pills.

Folic Acid
Alphacalcidol
Calcichew

Rephrase that, Ian is supposed to take the above three.  Despite reminding, he never does.  Ironically, when he does take them, his bloods go all over the place, when he doesn't take them his bloods are good and he eats pretty much of what he wants although we do tend to have good, balanced meals.

He does, however, take his EPO - under duress.
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« Reply #62 on: August 25, 2006, 07:23:28 PM »

I take calcium carbonate 750 mg twice daily with meals.
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Zach
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« Reply #63 on: August 26, 2006, 09:46:13 AM »

Anyone finding that their CO2 levels are going below normal since taking Renagel?
Carbon Dioxide Normal = 20 - 30 MEQ/L
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
Zach
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"Still crazy after all these years."

« Reply #64 on: September 03, 2006, 10:06:07 AM »

I keep containers of each in my work truck , in my car, at home, and in my wifes purse ( probobly the most important place!)

That's a really good idea ... you'll have them practically everywhere you go.
Logged

Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
angieskidney
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« Reply #65 on: September 12, 2006, 05:15:53 AM »

I keep containers of each in my work truck , in my car, at home, and in my wifes purse ( probobly the most important place!)

That's a really good idea ... you'll have them practically everywhere you go.
Ya I find if I don't keep separate containers everywhere that I might forget my binders :(
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diagnosed ESRD 1982
PD 2/90 - 4/90, 5/02 - 6/05
Transplant 4/11/90
Hemo 7/05-present (Inclinic Fres. 2008k 3x/wk MWF)
geoffcamp
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« Reply #66 on: September 12, 2006, 03:05:56 PM »

I tried tums hated the taste (like that should matter)!  I am now on the Phoslo gel caps and they seem to be working well.
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Geoffrey Campbell
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angieskidney
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« Reply #67 on: September 13, 2006, 02:01:12 AM »

I tried tums hated the taste (like that should matter)!  I am now on the Phoslo gel caps and they seem to be working well.
I've only been offered Renegel. I hate the taste of most Tums (am VERY picky since the chalky taste is bad enough but also effects the taste of the food I am about to eat :( ...) but I have found I like the minty ones for dinners and the berries one for desserts.
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FREE Donor List for all Kidney Patients!

diagnosed ESRD 1982
PD 2/90 - 4/90, 5/02 - 6/05
Transplant 4/11/90
Hemo 7/05-present (Inclinic Fres. 2008k 3x/wk MWF)
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« Reply #68 on: September 13, 2006, 07:41:08 AM »

When I did take tums I found the the smooth dissolve type to be the best tasting.  They came in assorted fruit flavors and were ot as chalky.  Give them a try Angie!
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Geoffrey Campbell
Diagnosed with ESRD at 26
Transplanted in 1999 rejected 2001
In center hemodialysis since late 2001 3X a week 4 hours late evening 3rd shift
angieskidney
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« Reply #69 on: September 13, 2006, 08:38:09 AM »

When I did take tums I found the the smooth dissolve type to be the best tasting.  They came in assorted fruit flavors and were ot as chalky.  Give them a try Angie!
Good idea! I had just asked the Pharmacist and she said they will work just as well as the ones I already take :)
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FREE Donor List for all Kidney Patients!

diagnosed ESRD 1982
PD 2/90 - 4/90, 5/02 - 6/05
Transplant 4/11/90
Hemo 7/05-present (Inclinic Fres. 2008k 3x/wk MWF)
BigSky
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« Reply #70 on: October 01, 2006, 06:36:15 AM »

Anyone finding that their CO2 levels are going below normal since taking Renagel?
Carbon Dioxide Normal = 20 - 30 MEQ/L

Kinda late answer---maybe answer ;D

Anyway low CO2 levels can be caused by too much protein.
 

Considering that most patients have to intake much more protein than "normal" people that may be part of the reason for low Co2 levels.   
Mine runs 13.8.   Normal runs 21-30 with normal for dialysis patients not being less than 12.
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Jill D.
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« Reply #71 on: October 01, 2006, 07:19:12 PM »

I take 3 Phoslo with each meal; also pop one if I have a snack and happen to remember! Someone mentioned potassium earlier in this thread - I have to drink 80ml of Sodium Polystyrene Sulfonate (referred to as "K-axcelate") every night as a potassium binder. That is some nasty stuff. Some nights I gag as I try to get it down! :-X
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Diagnosed with FSGS in1990.
Started hemodialysis in April 2006.
Received a new kidney from my sister on Dec. 5, 2006.
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Zach
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« Reply #72 on: October 01, 2006, 09:14:24 PM »

Anyone finding that their CO2 levels are going below normal since taking Renagel?
Carbon Dioxide Normal = 20 - 30 MEQ/L

Kinda late answer---maybe answer ;D

Anyway low CO2 levels can be caused by too much protein.
 

Considering that most patients have to intake much more protein than "normal" people that may be part of the reason for low Co2 levels.   
Mine runs 13.8.   Normal runs 21-30 with normal for dialysis patients not being less than 12.



When I used Renagel exclusively as my phosphate binder, my CO2 dropped from an average of 25 down to 17.  I now use 2 PhosLo and 1 Renagel and my CO2 is back to 22.  I have been consuming the same amount (92 grams) and type of protein during the time that this occurred.

Of course, everyone's different, but ....

To quote K/DOQI Guidelines:

" ... the serum bicarbonate (as total CO2) should be monitored regularly at monthly intervals and correction of metabolic acidemia by maintaining serum bicarbonate at or above 22 mmol/L should be a goal of the management of individuals undergoing maintenance dialysis."

http://www.kidney.org/professionals/kdoqi/guidelines_updates/nut_a14.html
« Last Edit: October 01, 2006, 09:17:10 PM by Zach » Logged

Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
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« Reply #73 on: October 01, 2006, 09:40:50 PM »

When i was on Fosrenol, i never got heartburn, now that i am on Renagel, i get it every night, does anyone else have this problem?  Please Please Please advise,  it's driving me nuts...  :-\
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Zach
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« Reply #74 on: October 01, 2006, 09:42:27 PM »

When i was on Fosrenol, i never got heartburn, now that i am on Renagel, i get it every night, does anyone else have this problem?  Please Please Please advise,  it's driving me nuts...  :-\

That's the other reason why I reduced the renagel and added PhosLo.
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Uninterrupted in-center (self-care) hemodialysis since 1982 -- 34 YEARS on March 3, 2016 !!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
No transplant.  Not yet, anyway.  Only decided to be listed on 11/9/06. Inactive at the moment.  ;)
I make films.

Just the facts: 70.0 kgs. (about 154 lbs.)
Treatment: Tue-Thur-Sat   5.5 hours, 2x/wk, 6 hours, 1x/wk
Dialysate flow (Qd)=600;  Blood pump speed(Qb)=315
Fresenius Optiflux-180 filter--without reuse
Fresenius 2008T dialysis machine
My KDOQI Nutrition (+/ -):  2,450 Calories, 84 grams Protein/day.

"Living a life, not an apology."
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