|Title:||Benefits of Sevelamer on Markers of Bone Turnover in Taiwanese Hemodialysis Patients||Authors:||YU-FENG LIN
|Issue Date:||2010||Journal Volume:||109||Journal Issue:||9||Start page/Pages:||663-672||Source:||Journal of the Formosan Medical Association||Abstract:||
Background/Purpose: Sevelamer hydrochloride is a recently developed phosphate binder, which is a quaternary amine anion exchanger without calcium or aluminum. Sevelamer is effective in controlling hyperphosphatemia without increasing the calcium load in chronic hemodialysis (HD) patients. We investigated whether sevelamer restored bone metabolism in chronic HD patients. Methods: An 8-week, prospective, open-label, randomized study was conducted after a 2-week washout period in chronic hyperphosphatemic HD patients. This study compared the effect of sevelamer on markers of bone turnover with that of calcium acetate, as stratified by baseline serum intact parathyroid hormone (iPTH) level. Results: There was no difference in the changes of serum phosphorus, calcium-phosphorus product and serum iPTH between the sevelamer and the calcium acetate groups. However, more hypercalcemic events (12%) were documented under calcium acetate treatment. In patients with hypoparathyroidism, calcium acetate treatment decreased serum iPTH at the end of the study, while sevelamer did not. Increased serum alkaline phosphatase levels were found among patients receiving sevelamer treatment compared with those who received calcium acetate treatment. In those patients receiving sevelamer, the serum alkaline phosphatase level was also positively correlated to the sevelamer dosage (r = 0.246, p = 0.013). Conclusion: Sevelamer effectively reduces serum phosphorus with a lower incidence of hypercalcemic effects in HD patients. Sevelamer is an effective means of treatment for chronic hyperphosphatemic HD patients, especially those with hypoparathyroidism. ? 2010 Formosan Medical Association & Elsevier.
|ISSN:||0929-6646||DOI:||10.1016/S0929-6646(10)60107-6||SDG/Keyword:||alkaline phosphatase; aluminum salt; biological marker; calcium acetate; calcium carbonate; calcium phosphate; colecalciferol; parathyroid hormone; phosphorus; sevelamer; vitamin D; acetic acid derivative; alkaline phosphatase; biological marker; calcium acetate; calcium derivative; calcium phosphate; chelating agent; parathyroid hormone; phosphorus; polyamine; sevelamer; adult; alkaline phosphatase blood level; article; blood sampling; bone metabolism; bone turnover; clinical trial; constipation; controlled clinical trial; controlled study; diarrhea; drug capsule; drug dose titration; drug efficacy; drug safety; female; flatulence; gastrointestinal hemorrhage; gastrointestinal symptom; hemodialysis; hemodialysis patient; human; hyperkalemia; hyperphosphatemia; hypoparathyroidism; kidney failure; major clinical study; male; melena; nausea; nervous system; nervous system activity; parathyroid hormone blood level; prospective study; pruritus; randomized controlled trial; side effect; tablet formulation; Taiwan; treatment duration; treatment outcome; treatment response; aged; Asian; blood; bone remodeling; chemically induced disorder; chronic kidney failure; disorders of mineral, electrolyte and metal metabolism; drug effect; hypercalcemia; metabolism; middle aged; renal replacement therapy; Acetates; Adult; Aged; Alkaline Phosphatase; Asian Continental Ancestry Group; Biological Markers; Bone Remodeling; Calcium Compounds; Calcium Phosphates; Chelating Agents; Female; Humans; Hypercalcemia; Hyperphosphatemia; Kidney Failure, Chronic; Male; Middle Aged; Parathyroid Hormone; Phosphorus; Phosphorus Metabolism Disorders; Polyamines; Prospective Studies; Renal Dialysis; Treatment Outcome
|Appears in Collections:||醫學系|
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