Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients

W. N. Suki, R. Zabaneh, J. L. Cangiano, J. Reed, D. Fischer, L. Garrett, B. N. Ling, S. Chasan-Taber, M. A. Dillon, A. T. Blair, S. K. Burke

Research output: Contribution to journalArticle

419 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1130-1137
Number of pages8
JournalKidney international
Volume72
Issue number9
DOIs
StatePublished - Nov 2007

Keywords

  • Calcium
  • Hemodialysis
  • Mortality
  • Phosphate-binders
  • Phosphorus
  • Sevelamer

ASJC Scopus subject areas

  • Nephrology

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