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Efficacy and safety of sevelamer carbonate against hyperphosphatemia in maintenance hemodialysis patients |
HUO Yanhong, ZHANG Xin, ZHANG Wenbo,WANG Hui, and LI Hao |
Kidney Disease Division,the 7th Medical Center of Chinese PLA General Hospital, Beijing 100700, China |
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Abstract Objective To evaluate the efficacy and safety of sevelamer carbonate in the treatment of maintenance hemodialysis (MHD) patients with hyperphosphatemia. Methods Eigyty-one MHD patients treated in the Army General Hospital between May 2017 and January 2018 were enrolled in this study. They were divided into two groups.The treatment group (n=39) received sevelamer carbonate for 6 months while the control group (n=42) received calcium acetate. The therapeutic effect was evaluated according to the changes of serum phosphorus, calcium, calcium-phosphate products, iPTH and LDL-C. The adverse effect was recorded simultaneously. Results (1) After treatment, levels of serum phosphorus decreased significantly at 2, 4 and 6 months (P<0.05) in the treatment group, but at 4 and 6 months in the control group(P<0.05). Two months after treatment, these levels in the treatment group were lower than those of the control group (P<0.05). (2) There was no significant change in serum calcium levels at 2, 4, and 6 months after treatment in the treatment group, but they were increased in the control group at 4 and 6 months after treatment (P<0.05). Compared with the control group, the serum calcium level in the treatment group was lower at 6 months after treatment (P<0.05). (3) Calcium and phosphorus levels were significantly decreased (P<0.05) after 2, 4 and 6 months of treatment in the treatment group, but after 6 months of treatment in the control group (P<0.05). They were lower in the treatment group than in the control group after 6 months of treatment (P<0.05).(4) iPTH levels decreased significantly after treatment in both groups (P<0.05). (5)Low density lipoprotein in the experimental group decreased significantly after 6 months of treatment (P<0.05), but there was no significant change after 6 months of treatment in the control group. (6)There was no significant difference in the incidence of adverse reactions between the two groups. Conclusions Sevelamer carbonate is safe and effective in treating hyperphosphatemia in patients with maintenance dialysis, and has the advantage of reducing the level of calcium-phosphorus products and low density lipoprotein compared with calcium acetate.
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Received: 10 August 2018
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