title: Effect of sevelamer on aortic pulse wave velocity in patients on hemodialysis: a prospective observational study.
abstract: Aortic stiffening and aortic calcification are risk factors for cardiovascular events in hemodialysis (HD) patients, and these 2 risk factors are interrelated. Sevelamer decreases aortic calcification but its effect on aortic stiffness has not been investigated previously. Thirteen HD patients commencing sevelamer treatment and 13 matched controls were followed for 11 months. Aortic pulse wave velocity (PWV), augmentation index (AIx), and levels of inhibitors of vascular calcification (fetuin-A, matrix-GLA-protein, osteoprotegerin/RANKL) were measured at baseline and at the end of follow-up, and the differences between the groups were compared. Determinants of the changes in PWV during follow-up were assessed by multivariate linear regression. At baseline, PWV was 9.93 (2.10) m/s in sevelamer-treated patients and 9.20 (2.84) m/s in control patients (p=0.464). By the end of follow-up, PWV decreased by 0.83 (2.3) m/s in sevelamer-treated patients while it increased by 0.93 (1.88) m/s in controls (p=0.042). The direction of changes in AIx were similar, but not statistically significant. There were no significant differences in the levels of inhibitors of calcification either at baseline or during follow-up. In multivariate linear regression sevelamer treatment, diabetes, heart rate, and C-reactive protein were related to the change in PWV. These data suggest that sevelamer treatment is associated with an improvement in aortic stiffness in HD patients, but it does not seem to affect serum levels of inhibitors of vascular calcification.
authors: 1st Department of Medicine, Semmelweis University, 2/a Korányi S, Budapest, Hungary.
authors: Taha El Hadj
authors: Tel H
authors: Othmane
authors: Geza
authors: G
authors: Bakonyi
authors: Jozsef
authors: J
authors: Egresits
authors: Bertalan Cs
authors: BC
authors: Fekete
authors: Erzsebet
authors: E
authors: Fodor
authors: Zoltan
authors: Z
authors: Jarai
authors: Csaba
authors: C
authors: Jekkel
authors: Janos
authors: J
authors: Nemcsik
authors: Andras
authors: A
authors: Szabo
authors: Tamas
authors: T
authors: Szabo
authors: Istvan
authors: I
authors: Kiss
authors: Andras
authors: A
authors: Tisler
mesh_terms: D001783:Blood Flow Velocity / Q000187:drug effects; D002114:Calcinosis / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011073:Polyamines / Q000008:administration & dosage / Q000494:pharmacology*; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000187:drug effects*; D006435:Renal Dialysis / Q000379:methods; D000069603:Sevelamer; D014655:Vascular Resistance / Q000187:drug effects*
chemical_list: D011073:Polyamines; D000069603:Sevelamer