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Calcium Acetate – a phosphate binder for kidney bone disease
Calcium acetate is a phosphate binding tablet for CKD patients

What is Calcium Acetate?
- A phosphate binder used to treat high phosphate levels (hyperphosphataemia), most commonly in people with chronic kidney disease (CKD).
- It works by binding phosphate from food, reducing how much phosphate is absorbed into the blood.
How it works
- The mechanism of action of calcium acetate involves binding to dietary phosphate in the gut
- As a phosphate binder, calcium acetate forms insoluble compounds with phosphate that are excreted in the stool.
- This process lowers blood phosphate levels, which helps maintain healthier bones in patients with chronic kidney disease.
Uses
Calcium acetate is used for patients with:
- Hyperphosphataemia in chronic kidney disease (CKD)
- This includes patients receiving haemodialysis or peritoneal dialysis
Dosage
- Dose: The usual dose of calcium acetate (475 mg) is taken with meals and adjusted according to blood phosphate levels
- Calcium acetate is available as capsules, tablets, or liquid – commonly 1–2 tablets/capsules with each meal
- Dose adjustments: Based on phosphate and calcium blood tests
Note. Calcium acetate should be taken exactly as prescribed, and doses should not be changed without medical advice.
Side-effects
Most calcium acetate side effects are mild but may be linked to raised calcium levels.
- Nausea
- Constipation
- Reduced appetite
Signs of high calcium levels (hypercalcaemia)
- Itching
- Red eyes
- Weakness
- Confusion
- Increased thirst or urination
Note. Medical advice should be sought soon if these symptoms of hypercalcaemia occur.
Monitoring
Doctors should monitor:
- Blood phosphate levels
- Blood calcium levels
- Parathyroid hormone levels (PTH), if required
- Kidney function tests (e.g. creatinine and GFR)
Blood tests should be more frequent when starting treatment or adjusting the dose.