Chronic acid-base perturbations in hemodialysis patients treated with sevelamer hydrochloride: a two-year follow-up study.
Sevelamer hydrochloride (HCl) contains multiple amines that may cause a significant dietary acid load. To evaluate the impact of sevelamer on arterial blood gases, we followed two groups of stable hemodialysis patients for 24 months. The Sevelamer Group (n = 7) did not achieve the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) goals for phosporus and Ca x P product and was switched from a calcium-based to sevelamer-based regimen. The Calcium Group (n = 7) achieved those goals and remained on calcium salts. Following sevelamer administration, a deterioration of chronic metabolic acidosis was revealed, which lasted throughout the study. Sevelamer therapy was associated with reduced cholesterol levels, improved serum phosphate, and Ca x P product, which facilitated the management of secondary hyperparathyroidism. No significant changes in acid-base status or other parameter tested were found in the Control Group. In conclusion, sevelamer intake caused small but persistent acid-base disturbances, which did not neutralize sevelamer's beneficial effects on mineral and lipid metabolism.
Vlahakos
Demetrios V
DV
ATTIKON University Hospital, Haidari, Athens, Greece. vlahakos@otenet.gr
Retsa
Kalliopi
K
Kalogeropoulou
Sofia
S
Katsoudas
Spiros
S
Bacharaki
Dimitra
D
Agroyannis
Basil
B
D000137:Acid-Base Imbalance / Q000139:chemically induced*; D000368:Aged; D001784:Blood Gas Analysis; D001842:Bone and Bones / Q000378:metabolism*; D002614:Chelating Agents / Q000009:adverse effects*; D004573:Electrolytes / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000378:metabolism*; D011073:Polyamines / Q000009:adverse effects*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects; D000069603:Sevelamer
D002614:Chelating Agents; D004573:Electrolytes; D008903:Minerals; D011073:Polyamines; D000069603:Sevelamer