[Sevelamer:hydrochloride].
The recent global breakthrough in the field of renal osteodystrophy is the inhibitory effect of sevelamer hydrochloride on the progression of coronary artery calcification, which was revealed with EBCT (Electron beam computed tomography) 1) approximately 3). It has been found that the degree of coronary artery calcification assessed with EBCT is proportional to the mortality risk by the coronary artery stenosis and by myocardial infarction in non-hemodialysis patients 4) approximately 10). In 2004 in Japan Matsuoka and Iseki et al showed for the first time in the world that coronary artery calcification assessed by EBCT was correlated with mortality 11). In Japan, however, it is difficult to administer sevelamer hydrochloride to many patients because of constipation as its side effect. Its prescription rate is 26.8% and its single administration rate is only 15.4% 12). We explained fully to the patients that sevelamer hydrochloride seldom caused coronary artery calcification. And we used sorbitol, an osmotic purgatives, with sevelamer hydrochloride. Moreover, we gradually replaced calcium carbonate with sevelamer hydrochloride in supper at first. With protocol above, we succeeded in having 86.7% of the patients take sevelamer hydrochloride 12). We think that it is important to increase the intake rate of sevelamer hydrochloride in order to prevent coronary artery calcification and to aim at the long survival of the patients.
Hyodo
Toru
T
Kidney Center, Yokohama Daiichi Hospital, Department of Urology, Kitasato University School of Medicine, Japan.
Taira
Takayasu
T
Wakai
Haruki
H
Takemura
Toru
T
Yamamoto
Sumiko
S
Yashida
Kazunari
K
Baba
Shiro
S
D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D002400:Cathartics / Q000008:administration & dosage; D003248:Constipation / Q000139:chemically induced / Q000453:epidemiology; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data; D004852:Epoxy Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D011073:Polyamines; D011095:Polyethylenes / Q000008:administration & dosage / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000009:adverse effects; D012306:Risk; D000069603:Sevelamer; D013012:Sorbitol / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
D002400:Cathartics; D004852:Epoxy Compounds; D011073:Polyamines; D011095:Polyethylenes; D013012:Sorbitol; D000069603:Sevelamer