Effects of sevelamer hydrochloride and calcium carbonate on renal osteodystrophy in hemodialysis patients

• Type: Article in International Scientific Journal
• Date: 2008

Authors

Ferreira, A (Author) Other; João Frazão (Author) FMUP; Monier Faugere, MC (Author) Other; Gil, C (Author) Other; Galvao, J (Author) Other; Oliveira, C (Author) Other; Baldaia, J (Author) Other; Rodrigues, I (Author) Other; Santos, C (Author) Other; Ribeiro, S (Author) Other; Hoenger, RM (Author) Other; Duggal, A (Author) Other; Malluche, HH (Author) Other

Journal

Title: Journal of the American Society of Nephrology

Vol. 19 No. 2

Pages: 405-412

ISSN: 1046-6673

Publisher: American Society of Nephrology

Indexing

ISI Web of Knowledge - 138 Citations

Scopus - 145 Citations

Other information

Authenticus ID: P-004-1VZ

DOI: 10.1681/asn.2006101089

Abstract (EN): Disturbances in mineral metabolism play a central role in the development of renal bone disease. In a 54-wk, randomized, open-label study, 119 hemodialysis patients were enrolled to compare the effects of sevelamer hydrochloride and calcium carbonate on bone. Biopsy-proven adynamic bone disease was the most frequent bone abnormality at baseline (59%). Serum phosphorus, calcium, and intact parathyroid hormone were well controlled in both groups, although calcium was consistently lower and intact parathyroid hormone higher among patients who were randomly assigned to sevelamer. Compared with baseline values, there were no changes in mineralization lag time or measures of bone turnover (e.g., activation frequency) after 1 yr in either group. Osteoid thickness significantly increased in both groups, but there was no significant difference between them. Bone formation rate per bone surface, however, significantly increased from baseline only in the sevelamer group (P = 0.019). In addition, of those with abnormal microarchitecture at baseline (i.e., trabecular separation), seven of 10 in the sevelamer group normalized after 1 yr compared with zero of three in the calcium group. In summary, sevelamer resulted in no statistically significant changes in bone turnover or mineralization compared with calcium carbonate, but bone formation increased and trabecular architecture improved with sevelamer. Further studies are required to assess whether these changes affect clinical outcomes, such as rates of fracture.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8