Sevelamer-Induced Gastrointestinal Disease in 12 Patients with End-Stage Renal Disease: A Case Series

Abstract

Isolated case reports and case series have linked the use of sevelamer to severe intestinal inflammation and perforation among patients with end stage renal disease (ESRD). In this study we highlight 12 cases of biopsy proven sevelamer-induced gastrointestinal disease (SIGD) from a large urban community hospital over the course of five years. We describe baseline characteristics, sites and types of injury, histological findings, timing and dosing of sevelamer initiation compared to symptom onset, and in a smaller subset, endoscopic resolution post drug cessation. We also identify preexisting risk factors among affected patients that may have increased the risk of SIGD to help clinicians risk-stratify when considering initiation of sevelamer.