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Kidney Int. 2007 Nov;72(9):1130-7. Epub 2007 Aug 29.

Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients.

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  • 1Renal Section, Department of Medicine, The Kidney Institute, Baylor College of Medicine, Houston, Texas 77054, USA. wsuki@bcm.tmc.edu


Elevated serum phosphorus and calcium are associated with arterial calcification and mortality in dialysis patients. Unlike calcium-based binders, sevelamer attenuates arterial calcification but it is unknown whether sevelamer affects mortality or morbidity. In a multicenter, randomized, open-label, parallel design trial we compared sevelamer and calcium-based binders on all-cause and cause-specific mortality (cardiovascular, infection, and other) in prevalent hemodialysis patients. A total of 2103 patients were initially randomized to treatment and 1068 patients completed the study. All-cause mortality rates and cause-specific mortality rates were not significantly different. There was a significant age interaction on the treatment effect. Only in patients over 65 years of age was there a significant effect of sevelamer in lowering the mortality rate. There was a suggestion that sevelamer was associated with lower overall, but not cardiovascular-linked, mortality in older patients. We suggest that further research is needed to confirm these findings.

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