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RenaGel efficacy in severe secondary hyperparathyroidism
R Castro1, A Herman, C Ferreira
1NorDial Centro de Hemodiálise de Mirandela Avda. Ntra. Sra. Amparo. Edificio Panorama, r/c esq 5370 Mirandela, Portugal. ruicastro@mail.telepac.pt
Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia
|December 25, 2002
Summary
RenaGel effectively lowers phosphate levels in hemodialysis patients with severe secondary hyperparathyroidism. This phosphate binder also improves lipid profiles, offering a viable treatment option for this complex patient group.
Area of Science:
- Nephrology
- Clinical Pharmacology
Background:
- Hemodialysis patients often present with hypercalcemia and hyperphosphatemia, complicating treatment with traditional binders.
- RenaGel (sevelamer hydrochloride) offers an alternative phosphate binder without altering serum calcium or aluminum levels.
- Previous studies have limited data on RenaGel's efficacy in severe secondary hyperparathyroidism.
Observation:
- This study evaluated RenaGel's efficacy in hemodialysis patients with severe secondary hyperparathyroidism.
- Secondary outcomes included monitoring parathyroid hormone, serum lipids, uric acid, and bicarbonate.
- 18 adult hemodialysis patients with high PTH levels were included after a washout period.
Findings:
- RenaGel significantly reduced serum phosphorus levels.
- While parathyroid hormone levels remained stable, serum alkaline phosphatase increased.
- Treatment led to decreased LDL cholesterol and triglycerides, with stable Lipoprotein(a).
- Serum albumin and bicarbonate levels increased, while uric acid decreased.
Implications:
- RenaGel is confirmed as an effective phosphate binder for hemodialysis patients, including those with severe secondary hyperparathyroidism.
- The observed improvements in lipid profiles suggest broader cardiovascular benefits.
- The cost-effectiveness of initiating RenaGel in severe cases warrants consideration.