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Meta-analysis comparing sevelamer and calcium-based phosphate binders on cardiovascular calcification in hemodialysis

Qian Zhang1, Ming Li, Yanwen Lu

  • 1Division of Nephrology, Huashan Hospital, Fudan University, Shanghai, PR China.

Nephron. Clinical Practice
|April 29, 2010
PubMed

Insights

Sevelamer hydrochloride did not impact cardiovascular calcification in hemodialysis patients compared to calcium binders. However, sevelamer use showed trends toward lower C-reactive protein and higher alkaline phosphatase and parathyroid hormone levels.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Patients with cardiovascular disease on hemodialysis often experience accelerated cardiovascular calcification.
  • Phosphate binders are crucial for managing hyperphosphatemia in these patients.
  • Sevelamer hydrochloride and calcium-based binders are common therapeutic options.

Purpose of the Study:

  • To compare the effects of sevelamer hydrochloride versus calcium-based phosphate binders.
  • To evaluate impacts on coronary artery calcification, C-reactive protein, alkaline phosphatase, and intact parathyroid hormone.
  • To analyze data from a meta-analysis of relevant clinical trials.

Main Methods:

  • A meta-analysis was conducted using studies retrieved via Medline, Cochrane Library, and conference proceedings.
  • Keywords "sevelamer" and "Renagel" were utilized for study identification.
  • Eligibility, quality assessment, data abstraction, and analysis were performed on selected trials.

Main Results:

  • Fourteen studies with 3,271 patients were included in the analysis.
  • No significant difference in coronary artery calcium progression was observed between sevelamer and calcium groups.
  • Sevelamer use was associated with significantly lower C-reactive protein and higher alkaline phosphatase and intact parathyroid hormone levels.

Conclusions:

  • Sevelamer treatment did not alter cardiovascular calcification progression in hemodialysis patients.
  • A trend towards reduced C-reactive protein levels was noted with sevelamer.
  • Elevated alkaline phosphatase and intact parathyroid hormone levels were observed in the sevelamer group.
Abstract

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