Sevelamer hydrochloride: an effective phosphate binder in dialyzed children.
This pilot study was designed to evaluate the efficacy and acceptability of sevelamer hydrochloride as a phosphate binder in pediatric patients treated with dialysis. A 6-month open-label trial of sevelamer hydrochloride (Renagel) was initiated in 17 patients, aged 11.8+/-3.7 years, undergoing hemodialysis ( n=3) or peritoneal dialysis ( n=14). Following a 2-week washout period of the phosphate binders, serum phosphorus increased from 5.2+/-1.3 mg/dl to 7.5+/-2.2 mg/dl ( P<0.0002). After initiation of therapy with sevelamer hydrochloride, serum phosphorus levels decreased to 6.2+/-1.2 mg/dl ( P<0.01) during the first 8 weeks and final values were 6.3+/-1.5 mg/dl. Serum calcium concentration decreased during the washout period from 9.4+/-0.9 mg/dl to 8.9+/-1.5 mg/dl ( P<0.01); values remained unchanged thereafter. The serum calcium-phosphorus ion product decreased during the first 8 weeks and values did not change subsequently. Serum bicarbonate, parathyroid hormone, total cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol, and triglyceride levels did not change. The initial prescribed dose of sevelamer hydrochloride was 121+/-50 mg/kg (4.5+/-5 g/day) and the final prescribed dose was 163+/-46 mg/kg (6.7+/-2.4 g/day). Sevelamer hydrochloride was well tolerated and without adverse effects related to the drug.
Mahdavi
Homa
H
Division of Pediatric Nephrology, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA.
Kuizon
Beatriz D
BD
Gales
Barbara
B
Wang
He-Jing
HJ
Elashoff
Robert M
RM
Salusky
Isidro B
IB
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D004852:Epoxy Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood*; D010758:Phosphorus / Q000097:blood; D010865:Pilot Projects; D011073:Polyamines; D011095:Polyethylenes / Q000009:adverse effects / Q000627:therapeutic use*; D006435:Renal Dialysis; D000069603:Sevelamer; D014280:Triglycerides / Q000097:blood
D004852:Epoxy Compounds; D010281:Parathyroid Hormone; D010710:Phosphates; D011073:Polyamines; D011095:Polyethylenes; D014280:Triglycerides; D010758:Phosphorus; D002784:Cholesterol; D000069603:Sevelamer