Document Detail

Phosphate binders, cardiovascular calcifications and mortality: do we need another survival study with sevelamer?
MedLine Citation:
PMID:  20349415     Owner:  NLM     Status:  MEDLINE    
In chronic renal failure patients, hyperphosphatemia has been associated with vascular calcifications and increased cardiovascular morbidity and mortality. In vitro observations have shown that calcium and phosphate independently and synergistically induce calcifications in human vascular smooth muscle cells, suggesting an important role for both in the calcification process. Because non-calcium phosphate binders reduce serum phosphate without increasing the calcium load, as is the case with calcium-based phosphate binders, it has been speculated that treatment with sevelamer leads to less vascular calcification and better survival in chronic kidney disease. Although the use of sevelamer may slow the progression of vascular calcifications compared with calcium-based phosphate binders, the relationship of this surrogate marker with patients' cardiovascular mortality and survival is far from certain. To resolve this uncertainty and to determine the most cost-effective way to treat hyperphosphatemia in patients with end-stage renal disease, another randomized study analyzing mortality comparing sevelamer with calcium phosphate binders should be undertaken.
Armando L Negri
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of nephrology     Volume:  23     ISSN:  1121-8428     ISO Abbreviation:  J. Nephrol.     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-11-01     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  653-7     Citation Subset:  IM    
Metabolic Research Institute, Universidad del Salvador, Buenos Aires, Argentina.
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MeSH Terms
Calcinosis / drug therapy,  mortality*
Calcium / metabolism
Cardiovascular Diseases / mortality*
Chelating Agents / therapeutic use*
Hyperphosphatemia / complications,  drug therapy*
Kidney Failure, Chronic / complications*
Muscle, Smooth, Vascular / metabolism
Phosphates / metabolism*
Polyamines / therapeutic use*
Renal Dialysis*
Reg. No./Substance:
0/Chelating Agents; 0/Phosphates; 0/Polyamines; 182683-00-7/sevelamer; 7440-70-2/Calcium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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