HDCN Abstract:  ASN Annual Meeting -- San Francisco  

Kakuta T, Hyodo T, Tanaka R, et al.

Sevelamer Attenuates the Progression of Coronary Calcification and Serum Pentosidine Content (an AGE) by HPLC Assay in Haemodialysis Patients.

ASN Annual Meeting -- San Francisco
J Am Soc Nephrol (Nov) 18:708A 2007

Abnormalities of mineral and bone metabolism in patients with chronic kidney disease (CKD) has been recognized that abnormal mineral and bone metabolism in CKD not only produces bone lesions, but also influences the prognosis by causing ectopic calcification throughout the body including the blood vessels over the long term.

Sevelamer is a mineral-free phosphate binder not limited by the hypercalcaemia often encounterd when utilizing calcium- containing phosphate binder (CPB).

Method: We conducted a randomized clinical trial comparing combination therapy with CPB and Sevelamer with only CPB in 200 heomodialysis patients. Study outcomes included the targeted concentrations of serum phosphorus, calcium, and serum pentosidine concentration and calcification of the coronary arteries using a calcification score derived from multi slice (16 slices) computed tomography (CACS).

Result: Group 1: The group of combination therapy with CPB and Sevelamer (n=92). Group 2: The group of only CPB (n=91).Final serum calcium concentration was significantly higher in the group2. End of study values of serum calcium: (median: 8.9vs9.7, interquartile range:8.2vs9.2, 9.95vs10.35 mg/dl ,P<0.0001).Change of Serum pentosidine concentration (12 m) was significantly higher in the group2 (P<0.00001). End of study values of pentosidine concentration: (1.6vs2.1, 1.2vs1.5, 1.9vs2.5 pg/mg)Change of total CACS (12 m) was significantly higher in the group2 (P<0.001). End of study values of total CACS: (158.2vs776.7, 4.5vs327.7, 913.6vs1080.9). Change of CACS in right coronary artery (RCA) (12 m) was significantly higher in the group2 (P<0.001). End of study values of RCA CACS: (32.0vs150.6, 0vs6.8, 370.0vs913.6) We used Mann-Whitney U test as Statictical analysis of Change.

Conclusion: The present studies suggest that sevelamer attenuates the progression of coronary calcification and carbonyl stress in dialysis patients.

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