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Phosphate binders, cardiovascular calcifications and mortality: do we need another survival study with sevelamer?
J Nephrol. 2010 Nov-Dec; 23(6):653-7.JN

Abstract

In chronic renal failure patients, hyperphosphatemia has been associated with vascular calcifications and increased cardiovascular morbidity and mortality. In vitro observations have shown that calcium and phosphate independently and synergistically induce calcifications in human vascular smooth muscle cells, suggesting an important role for both in the calcification process. Because non-calcium phosphate binders reduce serum phosphate without increasing the calcium load, as is the case with calcium-based phosphate binders, it has been speculated that treatment with sevelamer leads to less vascular calcification and better survival in chronic kidney disease. Although the use of sevelamer may slow the progression of vascular calcifications compared with calcium-based phosphate binders, the relationship of this surrogate marker with patients' cardiovascular mortality and survival is far from certain. To resolve this uncertainty and to determine the most cost-effective way to treat hyperphosphatemia in patients with end-stage renal disease, another randomized study analyzing mortality comparing sevelamer with calcium phosphate binders should be undertaken.

Authors+Show Affiliations

Metabolic Research Institute, Universidad del Salvador, Buenos Aires, Argentina. negri@casasco.com.ar

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20349415

Citation

Negri, Armando L.. "Phosphate Binders, Cardiovascular Calcifications and Mortality: Do We Need Another Survival Study With Sevelamer?" Journal of Nephrology, vol. 23, no. 6, 2010, pp. 653-7.
Negri AL. Phosphate binders, cardiovascular calcifications and mortality: do we need another survival study with sevelamer? J Nephrol. 2010;23(6):653-7.
Negri, A. L. (2010). Phosphate binders, cardiovascular calcifications and mortality: do we need another survival study with sevelamer? Journal of Nephrology, 23(6), 653-7.
Negri AL. Phosphate Binders, Cardiovascular Calcifications and Mortality: Do We Need Another Survival Study With Sevelamer. J Nephrol. 2010 Nov-Dec;23(6):653-7. PubMed PMID: 20349415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Phosphate binders, cardiovascular calcifications and mortality: do we need another survival study with sevelamer? A1 - Negri,Armando L, PY - 2009/09/11/accepted PY - 2010/3/30/entrez PY - 2010/3/30/pubmed PY - 2011/1/21/medline SP - 653 EP - 7 JF - Journal of nephrology JO - J Nephrol VL - 23 IS - 6 N2 - In chronic renal failure patients, hyperphosphatemia has been associated with vascular calcifications and increased cardiovascular morbidity and mortality. In vitro observations have shown that calcium and phosphate independently and synergistically induce calcifications in human vascular smooth muscle cells, suggesting an important role for both in the calcification process. Because non-calcium phosphate binders reduce serum phosphate without increasing the calcium load, as is the case with calcium-based phosphate binders, it has been speculated that treatment with sevelamer leads to less vascular calcification and better survival in chronic kidney disease. Although the use of sevelamer may slow the progression of vascular calcifications compared with calcium-based phosphate binders, the relationship of this surrogate marker with patients' cardiovascular mortality and survival is far from certain. To resolve this uncertainty and to determine the most cost-effective way to treat hyperphosphatemia in patients with end-stage renal disease, another randomized study analyzing mortality comparing sevelamer with calcium phosphate binders should be undertaken. SN - 1121-8428 UR - https://www.unboundmedicine.com/medline/citation/20349415/Phosphate_binders_cardiovascular_calcifications_and_mortality:_do_we_need_another_survival_study_with_sevelamer L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=20349415.ui DB - PRIME DP - Unbound Medicine ER -