A Comparison of Sevelamer Hydrochloride with Calcium Acetate on Biomarkers of Bone Turnover in Hemodialysis Patients

Liu, Yao‐Lung; Lin, Hsin‐Hung; Yu, Chung-Chieh; Kuo, Huey‐Liang; Yang, Yafei; Lin, Po-Wen; Liu, Jiung-Hsiun; Liao, Pen-Yuan; Huang, Chiu‐Ching

doi:10.1080/08860220600925388

Cited by 20 publications

(14 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Combined gastrointestinal adverse events occurred more often with sevelamer (four studies; n=384; RR, 1.42; 95% CI, 0.97 to 2.08) (16,17,19,34).…”

Section: Adverse Eventsmentioning

confidence: 99%

“…End of treatment serum Ca 3 P product did not differ significantly between sevelamer and CBBs (16 studies; n=2971; MD, 1.0 mg 2 /dl 2 ; 95% CI, 20.5 to 2.6 mg 2 /dl 2 ; heterogeneity: x 2 =27.90; I 2 =46%; P=0.02) (16,17,(19)(20)(21)(22)(23)(24)26,27,29,33,35,39,41,43).…”

Section: Biochemical End Pointsmentioning

confidence: 99%

“…The risk of hypercalcemia decreased significantly with sevelamer versus CBBs (RR, 0.30; 95% CI, 0.19 to 0.48) with significant heterogeneity (x 2 =34.56; I 2 =62%; P=0.001), in a meta-analysis of 15 studies (n=1537) (16,17,(19)(20)(21)(22)24,26,27,29,33,38,39,42,43). CBB-specific analyses were similar to the overall comparison without significant heterogeneity (x 2 =4.72; I 2 =57.6%; P=0.09).…”

Section: Biochemical End Pointsmentioning

confidence: 99%

“…Alkaline phosphatase levels showed no significant difference between sevelamer and CBB users in a meta-analysis of seven studies (n=352; MD, 28.4 m/L; 95% CI, 234.0 to 17.2 m/L; heterogeneity: x 2 =12.71; I 2 =53%; P=0.05) (14,16,18,19,23,24,26).…”

Section: Biochemical End Pointsmentioning

confidence: 99%

“…A meta-analysis of 23 studies (n=4010) showed no significant difference in end of treatment serum phosphate between sevelamer and CBBs (MD, 0.1 mg/dl; 95% CI, 20.1 to 0.2 mg/dl; heterogeneity: x 2 =109.14; I 2 =80%; P,0.001) or between sevelamer and Ca acetate, carbonate, or salts (14,(16)(17)(18)(19)(20)(21)(22)(23)(24)26,27,29,33,34,(37)(38)(39)(41)(42)(43)(44)(45). (Supplemental Figure 5).…”

Section: Biochemical End Pointsmentioning

confidence: 99%

See 4 more Smart Citations

Sevelamer Versus Calcium-Based Binders for Treatment of Hyperphosphatemia in CKD

Patel¹,

Bernard²,

Elder

2016

Clinical Journal of the American Society of Nephrology

154

106

View full text Add to dashboard Cite

Background and objectives People with CKD stages 3-5 and on dialysis (5D) have dramatically increased mortality, which has been associated with hyperphosphatemia in many studies. Oral phosphate binders are commonly prescribed to lower serum phosphate. We conducted an updated meta-analysis of the noncalcium-based binder (non-CBB) sevelamer versus CBBs in CKD stages 3-5D.Design, setting, participants, & measurements Randomized, controlled trials comparing sevelamer with CBBs were identified through MEDLINE and the Cochrane Central Register of Controlled Trials. Patient-level outcomes included all-cause mortality, cardiovascular events and mortality, hospitalization, and adverse effects. Intermediate outcomes included vascular calcification and bone changes. Biochemical outcomes included serum phosphate, calcium, parathyroid hormone, lipids, and hypercalcemia. We conducted and reported this review according to Cochrane guidelines. ResultsWe included 25 studies to March 31, 2015 with 4770 participants (88% on hemodialysis). Patients receiving sevelamer had lower all-cause mortality (risk ratio [RR], 0.54; 95% confidence interval [95% CI], 0.32 to 0.93), no statistically significant difference in cardiovascular mortality (n=2712; RR, 0.33; 95% CI, 0.07 to 1.64), and an increase in combined gastrointestinal events of borderline statistical significance (n=384; RR, 1.42; 95% CI, 0.97 to 2.08). For biochemical outcomes, patients receiving sevelamer had lower total serum cholesterol (mean difference [MD], 220.2 mg/dl; 95% CI, 225.9 to 214.5 mg/dl), LDL-cholesterol (MD, 221.6 mg/dl; 95% CI, 227.9 to 215.4 mg/dl), and calcium (MD, 20.4 mg/dl; 95% CI, 20.6 to 20.2 mg/dl) and a reduced risk of hypercalcemia (RR, 0.30; 95% CI, 0.19 to 0.48). End of treatment intact parathyroid hormone was significantly higher for sevelamer (MD, 32.9 pg/ml; 95% CI, 0.1 to 65.7 pg/ml). Serum phosphate values showed no significant differences.Conclusions Patients with CKD stages 3-5D using sevelamer have lower all-cause mortality compared with those using CBBs. Because of a lack of placebo-controlled studies, questions remain regarding phosphate binder benefits for patients with CKD stages 3-5 and not on dialysis.

show abstract

“…Combined gastrointestinal adverse events occurred more often with sevelamer (four studies; n=384; RR, 1.42; 95% CI, 0.97 to 2.08) (16,17,19,34).…”

Section: Adverse Eventsmentioning

confidence: 99%