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Expert Opin Pharmacother. 2014 Jul;15(10):1475-88. doi: 10.1517/14656566.2014.928285.

Efficacy of colestilan in the treatment of hyperphosphataemia in renal disease patients.

Author information

  • 1Alessandro Manzoni Hospital, Department of Nephrology Dialysis and Renal Transplantation , Via Dell'Eremo 9, Lecco, 23900 , Italy +39 0341 489850 ; +39 0341 489860 ; f.locatelli@ospedale.lecco.it.

Abstract

INTRODUCTION:

Hyperphosphataemia is common in chronic kidney disease (CKD), particularly in the late stages and is associated with secondary hyperparathyroidism, abnormal bone mineralisation and increased cardiovascular morbidity/mortality. At present, there is a range of phosphate binders designed to keep serum phosphate at normal or near normal levels. Colestilan is a new binder that offers additional actions that may afford further benefits over simply lowering phosphate.

AREAS COVERED:

This paper reviews the pharmacology and clinical data currently available in the use of colestilan to treat hyperphosphataemia in CKD stage 5 patients on dialysis.

EXPERT OPINION:

Available phosphate binders lower serum phosphorus levels to a clinically relevant extent. The balance between the risks and the potential benefits associated with each agent must be considered when choosing a binder. Calcium-based binders can lead to hypercalcaemia and/or positive calcium balance and cardiovascular calcification. Like sevelamer, colestilan is not absorbed and there is no evidence of any risk of hypercalcaemia. In addition, a significant lowering of low-density lipoprotein-cholesterol, similar to simvastatin, a reduction in plasma uric acid and a reduction in high glycosylated haemoglobin values suggest additional beneficial actions that may convert to reductions in mortality.

KEYWORDS:

chronic kidney disease; colestilan; dialysis; hyperphosphataemia; phosphate binder; tolerability

PMID:
24914480
[PubMed - indexed for MEDLINE]
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