Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients.

Abstract

Elevated serum phosphorus and calcium are associated with arterial calcification and mortality in dialysis patients. Unlike calcium-based binders, sevelamer attenuates arterial calcification but it is unknown whether sevelamer affects mortality or morbidity. In a multicenter, randomized, open-label, parallel design trial we compared sevelamer and calcium-based binders on all-cause and cause-specific mortality (cardiovascular, infection, and other) in prevalent hemodialysis patients. A total of 2103 patients were initially randomized to treatment and 1068 patients completed the study. All-cause mortality rates and cause-specific mortality rates were not significantly different. There was a significant age interaction on the treatment effect. Only in patients over 65 years of age was there a significant effect of sevelamer in lowering the mortality rate. There was a suggestion that sevelamer was associated with lower overall, but not cardiovascular-linked, mortality in older patients. We suggest that further research is needed to confirm these findings.

• Authors: W N Suki, R Zabaneh, J L Cangiano, J Reed, D Fischer, L Garrett, B N Ling, S Chasan-Taber, M A Dillon, A T Blair, S K Burke
• Journal: Kidney international (Kidney Int) Vol. 72 Issue 9 Pg. 1130-7 (Nov 2007) ISSN: 0085-2538 [Print] United States
• PMID: 17728707 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Acetates
• Calcium Compounds
• Chelating Agents
• Polyamines
• Phosphorus
• Sevelamer
• Calcium Carbonate
• Calcium
• calcium acetate

Topics

• Acetates (adverse effects, therapeutic use)
• Adult
• Age Factors
• Aged
• Calcium (blood)
• Calcium Carbonate (adverse effects, therapeutic use)
• Calcium Compounds (adverse effects, therapeutic use)
• Cardiovascular Diseases (etiology, mortality, prevention & control)
• Chelating Agents (adverse effects, therapeutic use)
• Chronic Disease
• Female
• Humans
• Kidney Diseases (complications, therapy)
• Male
• Middle Aged
• Phosphorus (blood)
• Polyamines (adverse effects, therapeutic use)
• Renal Dialysis (mortality)
• Sevelamer
• Treatment Outcome