title: Clinical efficacy of sevelamer hydrochloride in patients with end-stage renal disease: a retrospective study.
abstract: BACKGROUND
  Sevelamer hydrochloride (Renagel) is frequently used as a second-line phosphate binder in patients on renal replacement therapy. Many studies have shown that sevelamer can improve vascular calcification, serum uric acid and low-density lipoprotein (LDL) cholesterol levels. The main objectives of this study were to assess the efficacy of sevelamer against calcium-based phosphate binders, as well as its tolerability and side-effect profile.
  
  
  METHODS
  This was a retrospective study that included all patients on renal replacement therapy (between 2008 and 2011) who had previously received calcium-based binders for ≥ 6 months and were subsequently switched to sevelamer. Data collected from the patients' medical records included demographics, as well as renal parameters three months prior to sevelamer treatment, and at three and six months post treatment. The study excluded patients on multiple, concomitant phosphate binders or with functioning renal transplants, and those who were noncompliant or had inadequate follow-up blood investigations.
  
  
  RESULTS
  A total of 39 patients were included in the study. No major side effects were reported by any of the patients. There were improvements in calcium, phosphate, uric acid and LDL cholesterol levels at three and six months post-sevelamer treatment.
  
  
  CONCLUSIONS
  We found sevelamer to be superior to calcium-based phosphate binders in reducing serum calcium, phosphate, uric acid and LDL cholesterol levels in our patient population with advanced renal bone disease. Sevelamer also appears to be well tolerated with no significant side effects.
authors.affiliation: Renal Unit, Suri Seri Begawan Hospital, Kuala Belait Dialysis Center, Kuala Belait, Brunei Darussalam. drsartajalam@hotmail.com
authors.forename: Sartaj
authors.initials: S
authors.lastname: Alam
authors.forename: Asrar
authors.initials: A
authors.lastname: Hussain
authors.forename: Rajendra
authors.initials: R
authors.lastname: Daiwajna
authors.forename: Jackson
authors.initials: J
authors.lastname: Tan
mesh_terms: D000328:Adult; D001847:Bone Diseases / Q000150:complications; D002614:Chelating Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy; D054559:Hyperphosphatemia / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000737:chemistry; D011073:Polyamines / Q000627:therapeutic use*; D017582:Renal Replacement Therapy / Q000379:methods; D012189:Retrospective Studies; D000069603:Sevelamer; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D002614:Chelating Agents; D010710:Phosphates; D011073:Polyamines; D014527:Uric Acid; D000069603:Sevelamer