Abstract | UNLABELLED:
Sevelamer is a recent phosphate binder that is mineral-free, and represents a great advance in the treatment of hyperphosphatemia in patients with hypercalcemia and/or gastric intolerance to calcium-based phosphate binders. The communications about the experience with the use of sevelamer in patients non-yet in dialysis is scanty. The aim of our study is to investigate retrospectively the gastrointestinal tolerance of sevelamer, their efficacy as phosphate binder and other parameters in a group of 89 patients with chronic renal failure in predialysis. We have analysed the effects of sevelamer at baseline and after 1, 3 and 6 months on the following data and parameters: calcium, phosphate, intact PTH, venous bicarbonate, urea, creatinine, creatinine clearance, side-effects, number of patients that were discontinued, and co-treatment during the study period with phosphate-based binders, calcitriol, lipid-lowering drugs and sodium bicarbonate. RESULTS: 19 patients (21.3%) refused to continue with sevelamer at the first month (16 patients had digestive intolerance and 3 several symptoms). Serum phosphate fell at 3 months (5 +/- 0.8 mg/dl basal vs 4.8 +/- 0.7 mg/dl, p = 0.02) and 6 months (5 +/- 0.8 mg/dl basal vs 4.7 +/- 0.9 mg/dl, p = 0.07). Serum calcium fell at 6 months (9.8 +/- 0.7 mg/dl basal vs 9.4 +/- 0.6 mg/dl, p = 0.03). Venous bicarbonate and iPTH were unchanged, but the quantity of sodium bicarbonate administered increased significantly. Blood cholesterol fell at 1 months (193 +/- 49 mg/dl basal vs 173 +/- 52 mg/dl, p = 0.001) and 3 months (205 +/- 49 mg/dl basal vs 170 +/- 49 mg/dl, p = 0.004), in spite of a significant reduction of the dose of statins. CONCLUSIONS:
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Authors | M Suñer, A Guerrero, R Montes, M Rivera, A Ruiz, M Martínez-García, M A Pérez-Valdivia, J Mateos |
Journal | Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia
(Nefrologia)
Vol. 24
Issue 2
Pg. 142-8
( 2004)
ISSN: 0211-6995 [Print] Spain |
Vernacular Title | Tratamiento de la hiperfosfatemia con sevelamer en pacientes con insuficiencia renal crónica avanzada. |
PMID | 15219089
(Publication Type: English Abstract, Journal Article, Review)
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Chemical References |
- Bicarbonates
- Chelating Agents
- Epoxy Compounds
- Hypolipidemic Agents
- Parathyroid Hormone
- Phosphates
- Polyamines
- Polyethylenes
- Sevelamer
- Calcium
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Topics |
- Acid-Base Equilibrium
(drug effects)
- Adult
- Aged
- Aged, 80 and over
- Bicarbonates
(blood)
- Calcium
- Chelating Agents
(therapeutic use)
- Drug Evaluation
- Drug Therapy, Combination
- Epoxy Compounds
(adverse effects, therapeutic use)
- Female
- Follow-Up Studies
- Gastrointestinal Diseases
(chemically induced)
- Humans
- Hypercalcemia
(drug therapy)
- Hypercholesterolemia
(blood)
- Hypolipidemic Agents
(therapeutic use)
- Kidney Failure, Chronic
(blood, complications)
- Male
- Middle Aged
- Parathyroid Hormone
(blood)
- Patient Acceptance of Health Care
- Phosphates
(blood)
- Polyamines
- Polyethylenes
(adverse effects, therapeutic use)
- Retrospective Studies
- Sevelamer
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