Which phosphate binder is used when both calcium and phosphate levels are elevated?

Which phosphate binder is used when both calcium and phosphate levels are elevated?

• A. Sevelamer
• B. Calcium acetate
• C. Aluminum hydroxide
• D. Calcium carbonate

Answer: (A)

When both calcium and phosphate are elevated, choose a phosphate binder that does not add more calcium. Phosphate binders work in the gut to prevent dietary phosphate from being absorbed, helping to lower serum phosphate. If you use calcium-containing binders, they can raise calcium levels further, worsening hypercalcemia. Aluminum binders avoid calcium but carry risks of aluminum accumulation with long-term use. Sevelamer is a non-calcium, non-aluminum binder that binds phosphate in the gut and reduces absorption without increasing calcium, making it the best choice in this scenario.

When both calcium and phosphate are elevated, choose a phosphate binder that does not add more calcium. Phosphate binders work in the gut to prevent dietary phosphate from being absorbed, helping to lower serum phosphate. If you use calcium-containing binders, they can raise calcium levels further, worsening hypercalcemia. Aluminum binders avoid calcium but carry risks of aluminum accumulation with long-term use. Sevelamer is a non-calcium, non-aluminum binder that binds phosphate in the gut and reduces absorption without increasing calcium, making it the best choice in this scenario.