Document Detail


Sevelamer hydrochloride versus aluminum hydroxide: effect on serum phosphorus and lipids in CAPD patients.
MedLine Citation:
PMID:  16722024     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dietary phosphorus restriction, oral administration of phosphorus binders, and dialysis are the main strategies to control hyperphosphatemia in patients with stage 5 chronic kidney disease. Aluminum hydroxide (AH) and calcium carbonate, the most commonly used phosphorus binders, have serious disadvantages, such as aluminum toxicity and hypercalcemia. Sevelamer hydrochloride (SH) is a relatively new nonabsorbed calcium- and aluminum-free phosphorus binder. The present study was designed to evaluate the efficacy of SH in the control of hyperphosphatemia and its effect, compared to AH, on serum lipid parameters in patients on continuous ambulatory peritoneal dialysis (CAPD). METHODS: 30 stable patients on CAPD were included in an open-label, randomized crossover study. After a 2-week phosphorus binder washout period, 15 patients (group I) were administered SH for 8 weeks and in the remaining patients (group II), AH was introduced (phase A). After a new 2-week washout period, patients crossed over to the alternate agent for another 8 weeks (phase B). RESULTS: There were similar reductions in serum phosphorus levels over the course of the study with both agents: by 1.18 +/- 0.07 mg/dL (0.38 +/- 0.03 mmol/L) with SH and by 1.25 +/- 0.15 mg/dL (0.40 +/- 0.05 mmol/L) with AH in phase A (p = NS), and by 1.35 +/- 0.25 mg/dL (0.43 +/- 0.08 mmol/L) with AH and by 1.23 +/- 0.80 mg/dL (0.39 +/- 0.25 mmol/L) with SH in phase B (p = NS). Moreover, SH administration was associated with a 10.5% +/- 9.4% and a 20.1% +/- 6.8% fall in total cholesterol (p < 0.05) and low-density Lipoprotein cholesterol (p < 0.001) in phase A, and 11.9% +/- 7.2% (p < 0.05) and 21.5% +/- 2.4% (p < 0.001), respectively, in phase B. In both phases of the study, AH administration was not followed by a significant change in serum lipid parameters. CONCLUSION: Sevelamer hydrochloride is a well-tolerated alternative to calcium- or aluminum-containing phosphorus binder in the control of serum phosphorus in CAPD patients. Furthermore, SH improves the lipid profile in these patients.
Authors:
Konstantinos P Katopodis; Emilios K Andrikos; Chariklia D Gouva; Eleni T Bairaktari; Petros M Nikolopoulos; Lamprini K Takouli; Christos S Tzallas; Moses S Elisaf; Michael V Pappas; Kostas C Siamopoulos
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  26     ISSN:  0896-8608     ISO Abbreviation:  Perit Dial Int     Publication Date:    2006 May-Jun
Date Detail:
Created Date:  2006-05-25     Completed Date:  2006-10-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  320-7     Citation Subset:  IM    
Affiliation:
Department of Nephrology, University Hospital, University Hospital of Ioannina, Ioannina, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aluminum Hydroxide / adverse effects,  therapeutic use*
Cross-Over Studies
Female
Humans
Kidney Diseases / classification,  therapy
Lipids / blood*
Male
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory / methods*
Phosphates / blood*
Polyamines / adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Lipids; 0/Phosphates; 0/Polyamines; 182683-00-7/sevelamer; 21645-51-2/Aluminum Hydroxide
Comments/Corrections
Comment In:
Perit Dial Int. 2006 May-Jun;26(3):300-5   [PMID:  16722019 ]

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


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