title: Potential influence of sevelamer hydrochloride on responsiveness to erythropoiesis-stimulating agents in haemodialysis patients.
abstract: OBJECTIVE
  Vitamin D analogues, cinacalcet, and sevelamer play pivotal roles in the management of chronic kidney disease-mineral bone disorder, and are noted to have pleiotropic effects. We examined whether these agents might be associated with the responsiveness to erythropoiesis-stimulating agents (ESA).
  
  
  METHODS
  In this cross-sectional study including haemodialysis patients treated with ESA, we searched for clinical parameters associated with the ESA resistance index, which was calculated as the weekly ESA dose divided by the patient's haemoglobin value.
  
  
  RESULTS
  Among 45 patients (male: female = 28 : 17, age 68 ± 10 years, haemodialysis duration 84 ± 60 months), vitamin D analogue, cinacalcet, and sevelamer were used in 95.6%, 26.7%, and 84.4% of the patients, respectively. Univariate analysis showed significant association of the ESA resistance index with transferrin saturation rate (TSAT), vitamin D analogue dose, and sevelamer dose. In multivariate analysis, the sevelamer dose and TSAT were found to be independent determinants of the ESA resistance index.
  
  
  CONCLUSIONS
  Our preliminary data showed an independent association between sevelamer dose and the responsiveness to ESA in haemodialysis patients. Further studies are required to investigate the causal relationship between sevelamer and ESA responsiveness.
authors: Department of Nephrology and Dialysis, H. N. Medic Kitahiroshima, Kitahiroshima, Japan. i-key@hnmedic.jp
authors: Ryota
authors: R
authors: Ikee
authors: Masataka
authors: M
authors: Tsunoda
authors: Naomi
authors: N
authors: Sasaki
authors: Naritsugu
authors: N
authors: Sato
authors: Nobuo
authors: N
authors: Hashimoto
mesh_terms: D000368:Aged; D000069449:Cinacalcet; D003430:Cross-Sectional Studies; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000494:pharmacology; D011073:Polyamines / Q000494:pharmacology*; D006435:Renal Dialysis; D000069603:Sevelamer; D014807:Vitamin D / Q000031:analogs & derivatives*
chemical_list: D006397:Hematinics; D009281:Naphthalenes; D011073:Polyamines; D014807:Vitamin D; D000069603:Sevelamer; D000069449:Cinacalcet