S152 Gastrointestinal Tract Injuries Associated With Sevelamer: A Systematic Review

Abstract

Conclusion:MicroRNAs play an important role in CRC initiation, progression, and development through manipulation of cell stemness, angiogenesis, apoptosis, and the epithelial-mesenchymal transition (EMT) of tumor cells. With this study we identified unique clinically relevant metabolic pathways of CRC affected by downregulated miRNAs. We also identified the unique miRNAs hsa-mir-296b-3p and hsamir-198-3p. Further work is necessary to identify specific roles of these miRNA candidates as biological markers or therapeutic targets for patients with CRC. Table 1. List of the biological pathways identified from predicted target genes of downregulated miRNAs Pathway p-value #genes #miRNAs ECM-receptor interaction 4.97E-32 58 23 Proteoglycans in cancer 6.89E-12 124 26 Focal adhesion 5

Association of Sevelamer Initiation with Gastrointestinal Bleeding Hospitalization in Individuals Requiring Hemodialysis

“…Currently, there is no definitive evidence linking sevelamer to an increased risk of GIB, but concerns for an association have been raised [11,15,28]. A GI motility Fig.…”

“…effect [13,22,28] is compelling as sevelamer has been associated with increased GI side effects (including nausea, vomiting, diarrhea, and constipation) over other phosphate binders [38,39], but direct comparisons against calcium acetate [40,41] and sucroferric oxyhydroxide have been negative for GIB [42,43], as was a study examining sevelamer and risk of gastrointestinal perforation [44]. Alternatively, others have noted a mechanistic similarity between sevelamer and sodium polystyrene sulfonate, another exchange resin, which has been associated with gastrointestinal tract injury [11,17,25,45], which may be driven by sorbitol [46][47][48].…”

“…Given that gastrointestinal bleeding (GIB) has been the most common presenting symptom [13,28], we sought to evaluate the association between sevelamer initiation (vs. non-sevelamer containing phosphate binders) and incident GIB hospitalization among individuals requiring hemodialysis. We hypothesized that among individuals on dialysis without recent history of GIB hospitalization or phosphate binder use, sevelamer containing phosphate binders (vs. non-sevelamer containing binders) was associated with an increased rate of GIB hospitalization.…”