Sevelamer as a phosphate binder in adult hemodialysis patients: an evidence-based review of its therapeutic value

Abstract

Effective control of serum phosphate and Ca × P product to within K/DOQI target range Clear Sevelamer is as effective as calcium salts Absence of hypercalcemia Clear Reduced incidence of hypercalcemia with sevelamer compared with calcium salts Reduction in serum LDL cholesterol and total cholesterol Clear Sevelamer is more effective than calcium salts May have beneficial effects on cardiovascular morbidity and mortality Reduction in vascular calcification Substantial Attenuated progression with sevelamer compared with calcium salts May have beneficial effects on cardiovascular morbidity and mortality Metabolic acidosis Moderate Sevelamer may be more likely than calcium salts to induce metabolic acidosis Preservation of trabecular bone mineral density Limited Better preservation with sevelamer than with calcium salts May improve morbidity due to bone disease Patient-oriented evidence Improvement in cardiovascular morbidity and mortality Limited Reduced risk of cardiac mortality and morbidity with sevelamer compared with calcium salts continued overleaf… Reduction in serum uric acid concentration Moderate Greater reduction with sevelamer than with calcium salts