Role of sevelamer hydrochloride in the coronary artery calcification score.
The coronary artery calcification score (CACS) is higher in hemodialysis (HD) patients than in non-HD patients for each age group from the fifth to the eighth decade of life. In order to clarify the relationship between the rate of change in the CACS and several factors related to calcium (Ca) and phosphate (P) metabolism in HD patients, we determined the CACS twice in 144 HD outpatients at an interval of approximately 12 months (2003 and 2004). The dosage of vitamin D formulations (alfacalcidol or maxacalcitol) was reduced or ceased if the serum Ca concentration exceeded 5.0 mEq/L, or the serum P concentration exceeded 6.0 mg/dL, and the dosage of combined sevelamer hydrochloride (SH) and calcium carbonate (CaCO3), as the phosphate binder, was adjusted to maintain the concentrations below these levels. The study parameters were: (1) the total dosage of alfacalcidol (microg), maxacalcitol (microg), SH (mg), and CaCO3 at the time of each CACS measurement; and (2) serum concentrations of Ca, P, alkaline phosphatase, high-sensitivity parathyroid hormone (HS-PTH), total protein, albumin, total cholesterol, triglycerides (TG). Regression analysis showed a significant correlation among the total SH dosage, TG, and alphaCACS. Future investigations will include the differences in alphaCACS between patients treated with SH who experience a rise in Ca and/or P and those with a decrease in Ca and/or P.
Tsuruta
Yoshinari
Y
Department of Nephrology, Meiyo Clinic, Hemodialysis Center, Aichi, Japan. ytsuruta@meiyokai.or.jp
Kaneshiro
Kana
K
Narita
Yukio
Y
Obayashi
Takaaki
T
Fujii
Mikiko
M
Narita
Masayasu
M
Sasai
Kanna
K
Yoshimata
Takayuki
T
Watanabe
Yuzo
Y
Maeda
Kenji
K
D002114:Calcinosis / Q000097:blood / Q000175:diagnosis*; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D011073:Polyamines / Q000627:therapeutic use*; D012044:Regression Analysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D000069603:Sevelamer; D012720:Severity of Illness Index
D011073:Polyamines; D000069603:Sevelamer