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Nonphosphate-binding effects of sevelamer--are they of clinical relevance?
Semin Dial. 2008 Sep-Oct; 21(5):385-9.SD

Abstract

Sevelamer is an ion-exchanging resin that binds phosphate in the gut. Because it does so without increasing the calcium load, treatment with sevelamer may lead to less vascular calcification and better survival in chronic kidney disease patients. However, the results of available clinical studies have not been consistent; recent observations challenge the hypothesis that the extra calcium load inherent in calcium-based phosphate binder therapy increases cardiovascular mortality by accelerating vascular calcification. This reemphasizes the fact that we still lack detailed understanding on the complex relationships between vascular calcification, bone metabolism, vascular disease and outcome in the context of uremia. Thus, the role of phosphate binders may be more complex than initially anticipated and not limited to the extra calcium load. Even if detailed mechanisms of action for sevelamer are not yet clearly established (except for its lipid-lowering action), sevelamer may have a number of additional nonphosphate-lowering actions (including lipid lowering as well as improvement in endothelial function, modulation of inflammation and oxidative stress and binding of uremic toxin absorption). Whether these potentially very interesting pleiotropic effects of sevelamer may be translated into significant clinical benefits remains to be established.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Editorial
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

18573137

Citation

Marangon, Nicola, et al. "Nonphosphate-binding Effects of Sevelamer--are They of Clinical Relevance?" Seminars in Dialysis, vol. 21, no. 5, 2008, pp. 385-9.
Marangon N, Lindholm B, Stenvinkel P. Nonphosphate-binding effects of sevelamer--are they of clinical relevance? Semin Dial. 2008;21(5):385-9.
Marangon, N., Lindholm, B., & Stenvinkel, P. (2008). Nonphosphate-binding effects of sevelamer--are they of clinical relevance? Seminars in Dialysis, 21(5), 385-9. https://doi.org/10.1111/j.1525-139X.2008.00440.x
Marangon N, Lindholm B, Stenvinkel P. Nonphosphate-binding Effects of Sevelamer--are They of Clinical Relevance. Semin Dial. 2008 Sep-Oct;21(5):385-9. PubMed PMID: 18573137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonphosphate-binding effects of sevelamer--are they of clinical relevance? AU - Marangon,Nicola, AU - Lindholm,Bengt, AU - Stenvinkel,Peter, Y1 - 2008/06/19/ PY - 2008/6/25/pubmed PY - 2009/3/4/medline PY - 2008/6/25/entrez SP - 385 EP - 9 JF - Seminars in dialysis JO - Semin Dial VL - 21 IS - 5 N2 - Sevelamer is an ion-exchanging resin that binds phosphate in the gut. Because it does so without increasing the calcium load, treatment with sevelamer may lead to less vascular calcification and better survival in chronic kidney disease patients. However, the results of available clinical studies have not been consistent; recent observations challenge the hypothesis that the extra calcium load inherent in calcium-based phosphate binder therapy increases cardiovascular mortality by accelerating vascular calcification. This reemphasizes the fact that we still lack detailed understanding on the complex relationships between vascular calcification, bone metabolism, vascular disease and outcome in the context of uremia. Thus, the role of phosphate binders may be more complex than initially anticipated and not limited to the extra calcium load. Even if detailed mechanisms of action for sevelamer are not yet clearly established (except for its lipid-lowering action), sevelamer may have a number of additional nonphosphate-lowering actions (including lipid lowering as well as improvement in endothelial function, modulation of inflammation and oxidative stress and binding of uremic toxin absorption). Whether these potentially very interesting pleiotropic effects of sevelamer may be translated into significant clinical benefits remains to be established. SN - 1525-139X UR - https://www.unboundmedicine.com/medline/citation/18573137/Nonphosphate_binding_effects_of_sevelamer__are_they_of_clinical_relevance L2 - https://doi.org/10.1111/j.1525-139X.2008.00440.x DB - PRIME DP - Unbound Medicine ER -