Serological cardiovascular and mortality risk predictors in dialysis patients receiving sevelamer: a prospective study.
Abstract | BACKGROUND: METHODS: RESULTS: Forty-one patients finished the three prospective study phases (intention-to-treat analysis). After treatment with sevelamer, serum fetuin-A significantly increased (+21%), showing a delayed increase outlasting the third (non- sevelamer) study period. Total and low-density lipoprotein ( LDL) cholesterol levels, as well as serum calcium, decreased significantly. The opposite occurred with albumin, C-reactive protein and intact parathyroid hormone (iPTH). FGF23, uric acid, indoxyl sulphate, hippuric acid, indole acetic acid, CMPF and serum phosphate did not change significantly during sevelamer treatment. In contrast, in parallel to sevelamer treatment, there was a significant rise in serum P-cresol. CONCLUSIONS: In haemodialysis patients, treatment with sevelamer over 8 weeks was associated with a delayed yet long-lasting increase in serum fetuin-A levels. Increasing the serum level of fetuin-A, a negative acute-phase protein and systemic calcification inhibitor, might be one of the potential anti-calcification mechanisms of sevelamer. Since we failed to detect a decrease in systemic inflammation and uraemic toxins, the exact mechanisms by which sevelamer treatment affects serum fetuin-A remain to be determined.
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Authors | Vincent Matthias Brandenburg, Georg Schlieper, Nicole Heussen, Stefan Holzmann, Birgit Busch, Pieter Evenepoel, Raymond Vanholder, Björn Meijers, Natalie Meert, Walter J Fassbender, Jürgen Floege, Willi Jahnen-Dechent, Markus Ketteler |
Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
(Nephrol Dial Transplant)
Vol. 25
Issue 8
Pg. 2672-9
(Aug 2010)
ISSN: 1460-2385 [Electronic] England |
PMID | 20172849
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- AHSG protein, human
- Blood Proteins
- Chelating Agents
- Cholesterol, LDL
- FGF23 protein, human
- Polyamines
- alpha-2-HS-Glycoprotein
- Fibroblast Growth Factor-23
- C-Reactive Protein
- Sevelamer
- Calcium
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Blood Proteins
(metabolism)
- C-Reactive Protein
(metabolism)
- Calcium
(blood)
- Cardiovascular Diseases
(epidemiology, mortality, prevention & control)
- Chelating Agents
(therapeutic use)
- Cholesterol, LDL
(blood)
- Chronic Disease
- Female
- Fibroblast Growth Factor-23
- Humans
- Kidney Diseases
(therapy)
- Kidney Failure, Chronic
(blood, complications, therapy)
- Male
- Middle Aged
- Polyamines
(therapeutic use)
- Predictive Value of Tests
- Prospective Studies
- Renal Dialysis
(methods)
- Retrospective Studies
- Risk Factors
- Sevelamer
- Survival Rate
- Young Adult
- alpha-2-HS-Glycoprotein
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