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8420882 
Journal Article 
Carboxylic acids in combination with calcium phosphate chelators and sodium bicarbonate for the treatment of uremia and hyperphosphatemia in patients with CKD stages 3, 4 and 5 
Hernández-Miramontes, JA; Hernández-Villanueva, JA; Pacifuentes-Orozco, A; Méndez-Durán, A 
2019 
116 
3 
101-109 
Spanish 
Background. Currently the conservative treatment of Chronic Kidney Disease (CKD) consists of the improvement of altered biochemical parameters (anemia, dyslipidemia, hyperuricemia, hyperkalemia, hyperphosphatemia, acidosis), treatment of the underlying disease and its complications. This study aims to confirm the effectiveness of carboxylic acids in combination with calcium carbonate, calcium lactate and sodium bicarbonate in the management of uremia and hyperphosphatemia in patients with CKD 3, 4 and 5 (KDIGO). Material and methods. An open, observational and retrospective clinical study was conducted in 20 patients with stage 3, 4 and 5 CKD who received treatment based on carboxylic acids plus calcium phosphate binders and sodium bicarbonate, with a minimum of 1 month and maximun of 5.5 years follow-up. No patient ingested alpha keto-analogs of amino acids, prebiotics or probiotics. Results. The baseline and final average values of urea 148.5 mg/dl and 106.17 mg/dL, p 0.043; phosphorus 6.7mg / dL and 4.7mg/dL, p 0.027; uric acid 8.64 mg/dL and 6.84 mg/dL, p 0.041; serum albumin 4.06 g/dL and 4.07 g/dL, p 0.179; serum creatinine 4.01 mg/dL and 4.58 mg/dL, p 0.001; and potassium 5.5 mEq/L and 6.08 mEq/L, p 0.34. Conclusions.The study showed that in patients with CKD the treatment based on carboxylic acids in combination with calcium binders phosphorus and sodium bicarbonate, significantly decrease the levels of urea and phosphorus, which opens the consideration to a new therapeutic option in medical practice worldwide immersed in a different mechanism of action. © 2019 Academia de Ciencias Médicas de Bilbao. All rights reserved. 
Carboxylic acids; Krebs cycle; Phosphorus; Transamination