Binders and snacks

[murf]

I am supposed to have two caltrate ans one renagel with each meal. I follow that plan to the letter. But I am wondering what happens when I have a snack. For example, do I have 2 + 1 tablets at morning tea of coffee and cake? What do others do? Do you cut down the binders for smaller meals? Do you change the quantity of pills if the food is not protein based?

[RightSide]

It's not the protein per se, it's the bioavailable phosphorus content.

Coca-Cola is high in phosphorus (from the phosphoric acid)--and in liquid form, it's readily absorbed.  On the other hand, brown rice contains significant phosphorus.  But only about 1/4 of it is absorbed by the body; the rest is bound to phytate.

And yes, I will try to apportion out my phosphorus binders for the day according to which foods or drinks are higher in bioavailable phosphorus.

For a steak dinner, I will have two or even three Tums.

For a light carb-heavy meal, I may have just one.

[RichardMEL]

yuck - Caltrate AND Renagel? Is your calcium a bit low too?

I am a bit similar to RightSide. I think about what sort of snack I am having and plan accordingly. If I'm having something that I know has PO4 in it, like something with cheese or whatever, then yes I have a binder, if it's just a coffee then I don't bother.

If your Phosphates are rising in your labs that will be an indication that maybe you're not taking enough binders for all the phos in your meals and need to adjust accordingly. It's not an exact science that's for sure.

(if I'm naughty and have a coke or something I do have an extra just for that)

[sullidog]

I'mnomrally take two with each meal, but snacks I just take how much phos is in, and meals I will take more then two depending on the phos.
Troy

[RightSide]

If your Phosphates are rising in your labs that will be an indication that maybe you're not taking enough binders for all the phos in your meals and need to adjust accordingly. It's not an exact science that's for sure.

The good news is that PO4 fluctuates only slowly month-to-month.  So if you see it rising in next month's blood test, you've got time to deal with it (maybe with more binders) before it gets too far out of whack.

On the other hand, if it's already out of whack (as it often is when you first start dialysis), it can take quite a while for it to get back into range.

[billybags]

We put our script in last week for Renagel and was told "the supplies from the manufacturer have run out." it could be weeks before they are replenished. What do you do? Are other countries buying them all up at a bumped up price.

[aharris2]

Get the doc to write a scrip for Renvela.

Genzyme, the manufacturer, is phasing out Renagel in favor of Renvela. That's probably why the supply from the manufacturer has run out.

Both have the same active ingredient - sevelamer, as sevelamer carbonate for Renvela or sevelamer hydrochloride for Renagel. Renvela is supposed to be easier on the GI tract.

In addition to being approved for use in the US by the FDA, it is also approved for use in Europe by the European Commission in both tablet and powder forms.

(Thanks, Billybags, for "forcing" me to do a little research. We have both here at home and were going to change over when the Renagel ran out. But my brother is fighting GI tract issues - we will change over today!)

Any feedback from anyone who has made this change?

[KICKSTART]

Just to let you know BB Renvela is the 'new' Renagel and it is already available in this country .. ive had it !

[Zach]

Actually, it can take only a couple of high-phosphorus snacks and forgetting to take your binders that can quickly raise your phosphorus.