Evaluation the role of sevelamer in reducing serum phosphate in patients with renal failure on hemodialysis with that of calcium carbonate

Abstract

Calcification of coronary artery, an important indicator of atherosclerosis, is a frequent finding in patient s with CKD. A lot of studies have shown that hyperphosphatemia, is the main factor in the development of cardiovascular calcification. Recently, the use of sevelamer has emerged as a substitute for calcium carbonate for the reduction of serum phosphate in patients with renal failure. The aim of the study is to compare the efficacy of sevelamer in reducing serum phosphate in patients with renal failure on hemodialysis with that of calcium carbonate. The study was conducted in the dialysis unit in Al-Diwaniya teaching hospital, Al-Diwaniya province, Iraq. The present case-control study included 48 CKD disease patients on regular hemodialysis. They were divided into 2 groups; the first received calcium carbonate as a PO4 reducing agent while the second group received sevelamer as a PO4 reducing agent and the then patients were followed up for 3 months. The results showed that treatment with calcium carbonate and sevelamer were successful in significantly reducing serum PTH and serum PO4 and also both were successful in raising mean serum calcium significantly; however, sevelamer was more powerful in reducing serum PO4 and in raising serum calcium than calcium carbonate. Nevertheless, the change in serum PTH in both groups was approximately similar with no significant difference in magnitude of reduction. It has been concluded that sevelamer is significantly better than calcium carbonate in reducing serum PO4 in CKD on regular hemodialysis.