Document Detail


Comparison of efficacy of the phosphate binders nicotinic acid and sevelamer hydrochloride in hemodialysis patients.
MedLine Citation:
PMID:  22982903     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Hyperphosphatemia is a significant risk factor for the development of ectopic calcification and coronary artery diseases in patients on hemodialysis (HD), and must be controlled with the use of phosphate binders. Studies comparing the effects of sevelamer and nicotinic acid, both similar non-calcium and non-aluminum phosphate binders, are not available. In this study, 40 patients on HD with a serum phosphorus level of more than 6 mg/dL were enrolled. After a two week washout period without phosphate binders, the patients were randomly divided into two equal groups (n = 20) and were started on nicotinic acid or sevelamer for a period of four weeks. The dose of nicotinic acid used was 500 mg and that of sevelamer was 1600 mg daily. Blood samples were drawn for the measurement of the total calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), triglyceride (TG), total cholesterol (Chol), high-density lipoprotein (HDL), low-density lipoprotein (LDL), uric acid and parathyroid hormone (PTH). Patients receiving sevelamer showed a significant reduction in serum P level (2.2 ± 0.69 mg/dL; P <0.0001) in comparison with the nicotinic acid group (1.7 ± 1.06 mg/dL; P = 0.004). Reduction in the Ca-P product was significantly different in the two groups; in the sevelamer group, it was 21 ± 7; (P <0.0001) while in the nicotinic acid group, it was 16 ± 11 (P = 0.007). Also, patients on sevelamer showed greater reduction in the mean TG level (38.9 ± 92 mg/dL; P = 0.005). No significant changes were observed in the mean serum Ca, total Chol, HDL, LDL, ALP and iPTH levels in the two study groups. Our short-term study suggests that although nicotinic acid reduced hyperphosphatemia, sevelamer showed higher efficacy in controlling hyperphosphatemia as well as the Ca-P product.
Authors:
Farrokhlagha Ahmadi; Fatemeh Shamekhi; Mahbob Lessan-Pezeshki; Mohammad Reza Khatami
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia     Volume:  23     ISSN:  1319-2442     ISO Abbreviation:  Saudi J Kidney Dis Transpl     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9436968     Medline TA:  Saudi J Kidney Dis Transpl     Country:  Saudi Arabia    
Other Details:
Languages:  eng     Pagination:  934-8     Citation Subset:  IM    
Affiliation:
Department of Nephrology Research Center, Tehran University of Medical Science, Imam Khomeni Hospital; Tehran, Iran.
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