title: Sevelamer hydrochloride and calcium bicarbonate reduce serum fibroblast growth factor 23 levels in dialysis patients.
abstract: Fibroblast growth factor 23 (FGF23) is a member of the fibroblast growth factor superfamily which displays a strong phosphaturic action and an inhibition of vitamin D 1-alpha hydroxylase activity. Fourty-six patients undergoing maintenance hemodialysis therapy participated in the study. They were randomly divided into 2 groups, and treated with either 3 g sevelamer hydrochloride+3 g of calcium bicarbonate (CaCO3), or 3 g of CaCO3 alone. Serum FGF23 levels were determined by a sandwich enzyme-linked immunosorbent assay (ELISA) system that detects the intact form of FGF23 molecules. Although the serum inorganic phosphate (Pi) levels were comparable before treatment, the levels were significantly lower in the patients treated with sevelamer hydrochloride+CaCO3 than those with CaCO3 alone after 4 weeks of treatment (P<0.05). Serum FGF23 levels significantly decreased after 4 weeks of the treatment with sevelamer hydrochloride+CaCO3 from the pretreatment levels (P<0.05), while no changes were found in the patients treated with CaCO3 alone. Thus, the use of sevelamer hydrochloride and CaCO3 reduced serum FGF23 levels in dialysis patients presumably through inhibiting phosphate load into the intestine.
authors.affiliation: Clinical Study Group, Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan. f-koiwa@sa2.so-net.ne.jp
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Koiwa
authors.forename: Junichiro J
authors.initials: JJ
authors.lastname: Kazama
authors.forename: Akihide
authors.initials: A
authors.lastname: Tokumoto
authors.forename: Noritaka
authors.initials: N
authors.lastname: Onoda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kato
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Okada
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nii-Kono
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Shigematsu
mesh_terms: D001639:Bicarbonates / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011073:Polyamines / Q000627:therapeutic use*; D006435:Renal Dialysis; D000069603:Sevelamer; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D001639:Bicarbonates; C000717427:FGF23 protein, human; D011073:Polyamines; D005346:Fibroblast Growth Factors; C031556:calcium bicarbonate; D000089703:Fibroblast Growth Factor-23; D000069603:Sevelamer