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Effects of sevelamer hydrochloride and calcium carbonate on renal osteodystrophy in hemodialysis patients.
J Am Soc Nephrol. 2008 Feb; 19(2):405-12.JA

Abstract

Disturbances in mineral metabolism play a central role in the development of renal bone disease. In a 54-wk, randomized, open-label study, 119 hemodialysis patients were enrolled to compare the effects of sevelamer hydrochloride and calcium carbonate on bone. Biopsy-proven adynamic bone disease was the most frequent bone abnormality at baseline (59%). Serum phosphorus, calcium, and intact parathyroid hormone were well controlled in both groups, although calcium was consistently lower and intact parathyroid hormone higher among patients who were randomly assigned to sevelamer. Compared with baseline values, there were no changes in mineralization lag time or measures of bone turnover (e.g., activation frequency) after 1 yr in either group. Osteoid thickness significantly increased in both groups, but there was no significant difference between them. Bone formation rate per bone surface, however, significantly increased from baseline only in the sevelamer group (P = 0.019). In addition, of those with abnormal microarchitecture at baseline (i.e., trabecular separation), seven of 10 in the sevelamer group normalized after 1 yr compared with zero of three in the calcium group. In summary, sevelamer resulted in no statistically significant changes in bone turnover or mineralization compared with calcium carbonate, but bone formation increased and trabecular architecture improved with sevelamer. Further studies are required to assess whether these changes affect clinical outcomes, such as rates of fracture.

Authors+Show Affiliations

Nephrology Department, Hospital Curry Cabral, Lisboa, Portugal.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18199805

Citation

Ferreira, Aníbal, et al. "Effects of Sevelamer Hydrochloride and Calcium Carbonate On Renal Osteodystrophy in Hemodialysis Patients." Journal of the American Society of Nephrology : JASN, vol. 19, no. 2, 2008, pp. 405-12.
Ferreira A, Frazão JM, Monier-Faugere MC, et al. Effects of sevelamer hydrochloride and calcium carbonate on renal osteodystrophy in hemodialysis patients. J Am Soc Nephrol. 2008;19(2):405-12.
Ferreira, A., Frazão, J. M., Monier-Faugere, M. C., Gil, C., Galvao, J., Oliveira, C., Baldaia, J., Rodrigues, I., Santos, C., Ribeiro, S., Hoenger, R. M., Duggal, A., & Malluche, H. H. (2008). Effects of sevelamer hydrochloride and calcium carbonate on renal osteodystrophy in hemodialysis patients. Journal of the American Society of Nephrology : JASN, 19(2), 405-12. https://doi.org/10.1681/ASN.2006101089
Ferreira A, et al. Effects of Sevelamer Hydrochloride and Calcium Carbonate On Renal Osteodystrophy in Hemodialysis Patients. J Am Soc Nephrol. 2008;19(2):405-12. PubMed PMID: 18199805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of sevelamer hydrochloride and calcium carbonate on renal osteodystrophy in hemodialysis patients. AU - Ferreira,Aníbal, AU - Frazão,João Miguel, AU - Monier-Faugere,Marie-Claude, AU - Gil,Célia, AU - Galvao,José, AU - Oliveira,Carlos, AU - Baldaia,Jorge, AU - Rodrigues,Ilidio, AU - Santos,Carla, AU - Ribeiro,Silvia, AU - Hoenger,Regula Mueller, AU - Duggal,Ajay, AU - Malluche,Hartmut H, AU - ,, Y1 - 2008/01/16/ PY - 2008/1/18/pubmed PY - 2008/3/1/medline PY - 2008/1/18/entrez SP - 405 EP - 12 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 19 IS - 2 N2 - Disturbances in mineral metabolism play a central role in the development of renal bone disease. In a 54-wk, randomized, open-label study, 119 hemodialysis patients were enrolled to compare the effects of sevelamer hydrochloride and calcium carbonate on bone. Biopsy-proven adynamic bone disease was the most frequent bone abnormality at baseline (59%). Serum phosphorus, calcium, and intact parathyroid hormone were well controlled in both groups, although calcium was consistently lower and intact parathyroid hormone higher among patients who were randomly assigned to sevelamer. Compared with baseline values, there were no changes in mineralization lag time or measures of bone turnover (e.g., activation frequency) after 1 yr in either group. Osteoid thickness significantly increased in both groups, but there was no significant difference between them. Bone formation rate per bone surface, however, significantly increased from baseline only in the sevelamer group (P = 0.019). In addition, of those with abnormal microarchitecture at baseline (i.e., trabecular separation), seven of 10 in the sevelamer group normalized after 1 yr compared with zero of three in the calcium group. In summary, sevelamer resulted in no statistically significant changes in bone turnover or mineralization compared with calcium carbonate, but bone formation increased and trabecular architecture improved with sevelamer. Further studies are required to assess whether these changes affect clinical outcomes, such as rates of fracture. SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/18199805/Effects_of_sevelamer_hydrochloride_and_calcium_carbonate_on_renal_osteodystrophy_in_hemodialysis_patients_ L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=18199805 DB - PRIME DP - Unbound Medicine ER -