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Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients
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Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients
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Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients
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Journal Article
Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients
2007
Overview
Elevated serum phosphorus and calcium are associated with arterial calcification and mortality in dialysis patients. Unlike calcium-based binders, sevelamer attenuates arterial calcification but it is unknown whether sevelamer affects mortality or morbidity. In a multicenter, randomized, open-label, parallel design trial we compared sevelamer and calcium-based binders on all-cause and cause-specific mortality (cardiovascular, infection, and other) in prevalent hemodialysis patients. A total of 2103 patients were initially randomized to treatment and 1068 patients completed the study. All-cause mortality rates and cause-specific mortality rates were not significantly different. There was a significant age interaction on the treatment effect. Only in patients over 65 years of age was there a significant effect of sevelamer in lowering the mortality rate. There was a suggestion that sevelamer was associated with lower overall, but not cardiovascular-linked, mortality in older patients. We suggest that further research is needed to confirm these findings.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Adult
/ Aged
/ calcium
/ Calcium Carbonate - adverse effects
/ Calcium Carbonate - therapeutic use
/ Calcium Compounds - adverse effects
/ Calcium Compounds - therapeutic use
/ Cardiovascular Diseases - etiology
/ Cardiovascular Diseases - mortality
/ Cardiovascular Diseases - prevention & control
/ Chelating Agents - adverse effects
/ Chelating Agents - therapeutic use
/ Female
/ Humans
/ Kidney Diseases - complications
/ Male
/ Polyamines - adverse effects
