Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Braun, J; Asmus, HG; Holzer, H; Brunkhorst, R; Krause, R; Schulz, W; Neumayer, HH; Raggi, P; Bommer, J.
Long-term comparison of a calcium-free phosphate binder and calcium carbonate--phosphorus metabolism and cardiovascular calcification.
Clin Nephrol. 2004; 62(2):104-115
Doi: 10.5414/CNP62104
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Holzer Herwig
- Krause Robert
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- Abstract:
- BACKGROUND: Calcium carbonate used as a phosphate binder may contribute to cardiovascular calcification. Long-term comparisons of sevelamer, a non-calcium polymeric phosphate binder, and calcium carbonate (CC) are lacking. METHODS: 114 adult hemodialysis patients were randomly assigned to open label sevelamer or CC for 52 weeks. Study efficacy endpoints included changes in serum phosphorus, calcium, calcium-phosphorus product, and lipids. In addition, initial and sequential electron beam computerized tomography scans were performed to assess cardiovascular calcification status and change during follow-up. Safety endpoints were serum biochemistry, blood cell counts and adverse events. RESULTS: Patients receiving sevelamer had a similar reduction in serum phosphorus as patients receiving CC (sevelamer -0.58 +/- 0.68 mmol/l, CC -0.52 +/- 0.50 mmol/l; p = 0.62). Reductions in calcium-phosphorus product were not significantly different (sevelamer -1.4 +/- 1.7 mmol2/l2, CC -0.9 +/- 1.2 mmol2/l2; p = 0.12). CC produced significantly more hypercalcemia (> 2.8 mmol/l in 0% sevelamer and 19% CC patients, p < 0.01) and suppressed intact parathyroid hormone below 150 pg/ml in the majority of patients. Sevelamer patients experienced significant (p < 0.01) reductions in total (-1.2 +/- 0.9 mmol/l, -24%) and LDL cholesterol (-1.2 +/- 0.9 mmol/l, -30%). CC patients had significant increases in coronary artery (median +34%, p < 0.01) and aortic calcification (median +32%, p < 0.01) that were not observed in sevelamer-treated patients. Patients on sevelamer required more grams of binder (sevelamer 5.9 g vs. CC 3.9 g) and experienced more dyspepsia than patients on calcium carbonate. CONCLUSIONS: Sevelamer is an effective phosphate binder that unlike calcium carbonate is not associated with progressive cardiovascular calcification in hemodialysis patients.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Calcinosis - etiology
- Calcium Carbonate - therapeutic use
- Cardiovascular Diseases - etiology
- Epoxy Compounds - therapeutic use
- Female - therapeutic use
- Humans - therapeutic use
- Kidney Failure, Chronic - complications
- Male - complications
- Middle Aged - complications
- Phosphorus - metabolism
- Polyamines - metabolism
- Polyethylenes - therapeutic use
- Renal Dialysis - therapeutic use
- Time Factors - therapeutic use
- Find related publications in this database (Keywords)
- calcification
- calcium
- hyperphosphatemia
- hyperparathyroidism
- phosphate
- sevelamer