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Hyperphosphatemia is a significant risk factor for the development of ectopic calcification and coronary artery diseases in patients on hemodialysis (HD), and must be controlled with the use of phosphate binders. Studies comparing the effects of sevelamer and nicotinic acid, both similar non-calcium and non-aluminum phosphate binders, are not available. In this study, 40 patients on HD with a serum phosphorus level of more than 6 mg/dL were enrolled. After a two week washout period without phosphate binders, the patients were randomly divided into two equal groups (n = 20) and were started on nicotinic acid or sevelamer for a period of four weeks. The dose of nicotinic acid used was 500 mg and that of sevelamer was 1600 mg daily. Blood samples were drawn for the measurement of the total calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), triglyceride (TG), total cholesterol (Chol), high-density lipoprotein (HDL), low-density lipoprotein (LDL), uric acid and parathyroid hormone (PTH). Patients receiving sevelamer showed a significant reduction in serum P level (2.2 ± 0.69 mg/dL; P <0.0001) in comparison with the nicotinic acid group (1.7 ± 1.06 mg/dL; P = 0.004). Reduction in the Ca-P product was significantly different in the two groups; in the sevelamer group, it was 21 ± 7; (P <0.0001) while in the nicotinic acid group, it was 16 ± 11 (P = 0.007). Also, patients on sevelamer showed greater reduction in the mean TG level (38.9 ± 92 mg/dL; P = 0.005). No significant changes were observed in the mean serum Ca, total Chol, HDL, LDL, ALP and iPTH levels in the two study groups. Our short-term study suggests that although nicotinic acid reduced hyperphosphatemia, sevelamer showed higher efficacy in controlling hyperphosphatemia as well as the Ca-P product.

The paper focuses on the development of a cryoprotective drying medium suitable for the application of probiotics in infant formulae. Response surface methodology was used to optimize the concentrations of skim milk and prebiotics for maximizing the survival of the probiotic Bifidobacterium lactis DSM 10140 during freeze-drying. The optimal combination was found to be 15.0% skim milk blended with 3.4% prebiotics, which protected viability in 62.16% of cells. There was no significant difference (p>0.05) between the experimental and predicted values, thereby verifying the model adequacy. The stability of the freezedried cells in the optimal combination of drying medium was examined under different conditions of rehydration and storage and in a simulated gastrointestinal tract model. The results showed that optimized drying medium could increase the viability of freeze-dried stationary phase cells by 1.34 log (CFU/ml) as compared to phosphate buffer after 120 days of storage at 4°C. However, with increasing temperature to 25°C, the protective effect of the optimized medium was more obvious. The optimized drying medium was also able to reduce the mortality rate of cells after sequential incubation under simulated infantile gastrointestinal conditions, including gastric conditions (pH 3.0 and 4.0, 90 min) and intestinal conditions (pH 7.5, 5 h) by 1.24 and 0.57 log (CFU/ml), respectively, compared to the control.

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