Efficacy of calcium glycerophosphate vs conventional mineral salts for total parenteral nutrition in low-birth-weight infants: A randomized clinical trial

To test the efficacy of calcium glycerophosphate (CaGlyP) vs the conventional mineral salts, calcium gluconate plus KH₂PO₄+K₂HPO₄ (CaGluc+P), in promoting mineral retention, 72-h mineral balance, biochemical status, net acid excretion, and growth were assessed in 16 low-birth-weight infants receiving total parenteral nutrition (TPN) containing ~1.5 mmol Ca and P·kg^-1·d^-1 for 5 d. Net retentions of calcium (1.2 ± 0.2 vs 1.0 ± 0.2 mmol·kg^-1·d^-1, x̄ ± SD) and phosphorus (1.1 ± 0.3 vs 0.8 ± 0.3 mmol·kg^-1·d^-1) from CaGluc+P vs CaGlyP, respectively, were similar, as were retentions of magnesium and sodium, urinary pH, and net acid excretion. Plasma ionized calcium, inorganic phosphorus, alkaline phosphatase, and osteocalcin were normal and not different between groups. CaGlyP is as effective as CaGluc+P in promoting mineral retention and normal mineral homeostasis. However, at intakes of ≤ 1.5 mmol Ca and P·kg^-1·d^-1 from either mineral salt, retention represented only 60% and 45%, respectively, of the predicted intrauterine accretion for calcium and phosphorus. Larger intakes permitted by the more-soluble CaGlyP may be desirable for infants receiving TPN.