Document Detail


Sevelamer carbonate increases serum bicarbonate in pediatric dialysis patients.
MedLine Citation:
PMID:  19876653     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sevelamer hydrochloride (HCl), a calcium-free phosphate binder, is increasingly used due to concerns related to calcium exposure and the development of vascular calcifications. However, a common side effect of sevelamer HCl, metabolic acidosis, is particularly concerning in children, as it can contribute to poor growth. Sevelamer carbonate is now available and has been shown to increase serum bicarbonate in adult patients. We conducted a prospective single-center study of pediatric dialysis patients comparing serum bicarbonate before and 3 months after a switch from sevelamer HCl to sevelamer carbonate. Inclusion criteria were a minimum of 3 months of dialysis therapy and either a serum bicarbonate <20 mmol/L or the need for sodium bicarbonate supplementation. Ten hemodialysis and 14 peritoneal dialysis patients, aged 16 +/- 3 years, were enrolled. Whereas serum calcium and phosphorus remained unchanged, serum bicarbonate increased from 20 (17.2-22.0) to 24.5 (20.75-26) mmol/L (p < 0.001) after 3 months of sevelamer carbonate therapy. Sodium bicarbonate supplementation was stopped in all patients (n = 10), reducing the mean daily sodium intake by an average of 2.3 g per patient. These results demonstrate that sevelamer carbonate is an effective phosphate binder that improves acid-base status in pediatric dialysis patients.
Authors:
Elsa Gonzalez; John Schomberg; Nimisha Amin; Isidro B Salusky; Joshua Zaritsky
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Publication Detail:
Type:  Journal Article     Date:  2009-10-30
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  25     ISSN:  1432-198X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  373-5     Citation Subset:  IM    
Affiliation:
Division of Pediatric Nephrology, Department of Pediatrics, Mattel Children's Hospital at UCLA, Box 951752, Los Angeles, CA 90095-1752, USA. elsagnt@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Chelating Agents
Female
Hemodialysis Solutions
Humans
Male
Peritoneal Dialysis / adverse effects,  methods*
Polyamines
Prospective Studies
Sodium Bicarbonate / blood*
Chemical
Reg. No./Substance:
0/Chelating Agents; 0/Hemodialysis Solutions; 0/Polyamines; 144-55-8/Sodium Bicarbonate; 182683-00-7/sevelamer

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


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