{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:32:49Z","timestamp":1740137569103,"version":"3.37.3"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T00:00:00Z","timestamp":1531180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007638","name":"Kidney Foundation, Japan","doi-asserted-by":"publisher","award":["JKFB16\u201033"],"award-info":[{"award-number":["JKFB16\u201033"]}],"id":[{"id":"10.13039\/501100007638","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ther Apher Dial"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Most patients undergoing dialysis are required to take many phosphate binder pills to control hyperphosphatemia. Phosphate binders prescribed in Japan are classified into two types: metal\u2010based binders (Ca carbonate, lanthanum carbonate, ferric citrate hydrate, and sucroferric oxyhydroxide) and chemically synthesized polymers (sevelamer hydrochloride and bixalomer). The raw materials of metal\u2010based phosphate binders are natural ores; thus, such binders may contain several other metallic elements. We measured the elemental contents in six metal\u2010based phosphate binders using an inductively coupled plasma mass \u2013 spectrometry (ICP\u2010MS) method. As a result, despite being in small amounts, ore\u2010derived phosphate binders contained various elements besides their active ingredient metals: Na, Mg, P, Mn, Fe, Sr, Y, Ba, La, Nd, and Pb in three Ca\u2010based products; Mg, P, Se, Ce, and Gd in one La\u2010based product; and Na, Mg, Al, P, Ca, Ti, Cr, Mn, Co, Ni, Ge, Ba, and La in two Fe\u2010based products. These elements are considered to have originated from pharmaceutical bulk and from pharmaceutical additives. It is unlikely these elements are immediately harmful to patients. However, it should be emphasized that patients undergoing dialysis do not have a urinary excretion route and are administered many phosphate binder pills every day over a long period of time. In the future, pharmaceutical companies may have to disclose standard amounts and\/or analytical values regarding the type and quantity of metallic elements in the final formulation or pharmaceutical bulk derived from natural ores.<\/jats:p>","DOI":"10.1111\/1744-9987.12704","type":"journal-article","created":{"date-parts":[[2018,7,10]],"date-time":"2018-07-10T09:46:12Z","timestamp":1531215972000},"page":"630-634","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Phosphate Binders Derived from Natural Ores Contain Many Kinds of Metallic Elements Besides Their Active Ingredient Metals"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6527-3286","authenticated-orcid":false,"given":"Nobuo","family":"Nagano","sequence":"first","affiliation":[{"name":"Kidney Disease and Dialysis Center Hidaka Hospital  Takasaki Japan"},{"name":"Department of Medicine, Medical Center East Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayako","family":"Minegishi","sequence":"additional","affiliation":[{"name":"Pharmaceutical Department Heisei Hidaka Clinic Hidaka\u2010kai  Takasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyoko","family":"Ito","sequence":"additional","affiliation":[{"name":"Kidney Disease and Dialysis Center Hidaka Hospital  Takasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuo","family":"Ando","sequence":"additional","affiliation":[{"name":"Kidney Disease and Dialysis Center Hidaka Hospital  Takasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaaki","family":"Tsutsui","sequence":"additional","affiliation":[{"name":"Kidney Disease and Dialysis Center Hidaka Hospital  Takasaki 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