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Endotoxin binding by sevelamer: potential impact on nutritional status.
Natsuki Kubotera1, Alexander J Prokopienko, Adinoyi O Garba
1Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY 12208, USA.
International Journal of Nephrology
|February 13, 2013
Summary
Sevelamer may reduce endotoxin (ET) levels in hemodialysis patients, potentially improving nutritional status. Further research is needed to confirm these effects on chronic kidney disease patients with elevated ET.
Area of Science:
- Nephrology
- Immunology
- Nutritional Science
Background:
- Hemodialysis patients exhibit high chronic inflammation and poor nutrition.
- Endotoxin (ET) triggers pro-inflammatory cytokines, negatively impacting protein metabolism.
- Elevated ET correlates with lower albumin and higher inflammation markers in hemodialysis patients.
Purpose of the Study:
- To investigate the impact of sevelamer on endotoxin (ET) levels in hemodialysis patients.
- To assess the association between ET reduction and changes in inflammatory markers and nutritional status.
- To explore sevelamer's potential therapeutic role in managing inflammation and nutrition in chronic kidney disease (CKD).
Main Methods:
- Review of observational and interventional studies on sevelamer therapy in hemodialysis patients.
- Analysis of serum ET concentrations, inflammatory cytokines (IL-1, IL-6, TNFα), C-reactive protein (CRP), and serum albumin.
- Evaluation of potential sources of ET, including bacterial translocation and iron supplementation.
Main Results:
- Observational and interventional studies suggest sevelamer reduces serum ET concentrations.
- Sevelamer therapy is associated with decreased TNFα, IL-6, and CRP levels.
- Improvements in serum albumin were noted in several small studies alongside ET reduction.
Conclusions:
- Sevelamer shows potential in reducing endotoxin (ET) and associated inflammation in hemodialysis patients.
- Observed improvements in nutritional markers like albumin suggest a beneficial role for sevelamer.
- Further comprehensive studies are required to establish sevelamer's efficacy in improving nutritional status in CKD patients with elevated ET.
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