title: Feasibility study of colestipol as an oral phosphate binder in hemodialysis patients.
abstract: BACKGROUND
  Currently available calcium- and aluminium-based phosphate binders are dose limited because of potential toxicity, and newer proprietary phosphate binders are expensive. We examined phosphate-binding effects of the bile acid sequestrant colestipol, a non-proprietary drug that is in the same class as sevelamer.
  
  
  METHODS
  The trial was an 8 week prospective feasibility study in stable hemodialysis patients using colestipol as the only phosphate binder, preceded and followed by a washout phase of all other phosphate binders. The primary study endpoint was weekly measurements of serum phosphate. Secondary endpoints were serum calcium, lipids and coagulation status. Analyses used random effects mixed models.
  
  
  RESULTS
  Thirty patients were screened for participation of which 26 met criteria for treatment. At a mean dose of 8.8 g/24 h of colestipol by study end, serum phosphate dropped from 2.24 to 1.96 mmol/L (P < 0.001). Three patients required calcium supplementation. LDL cholesterol dropped from 1.75 to 1.2 mmol/L (P < 0.001). Three patients dropped out because of side effects or intolerance of the required dose.
  
  
  CONCLUSIONS
  The results support the feasibility of a larger trial to determine the efficacy of colestipol as a phosphate binder and that other non-proprietary anion-exchange resins may also warrant investigation.
authors.affiliation: Department of Renal Medicine, Counties Manukau District Health Board, Shanghai, China; Faculty of Medical and Health Sciences, University of Auckland, Shanghai, China.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hood
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Wolley
authors.forename: Angela L
authors.initials: AL
authors.lastname: Kam
authors.forename: Jamie C
authors.initials: JC
authors.lastname: Kendrik-Jones
authors.forename: Mark R
authors.initials: MR
authors.lastname: Marshall
mesh_terms: D000284:Administration, Oral; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000187:drug effects; D002118:Calcium / Q000097:blood; D002614:Chelating Agents / Q000008:administration & dosage* / Q000009:adverse effects; D008078:Cholesterol, LDL / Q000097:blood; D003084:Colestipol / Q000008:administration & dosage* / Q000009:adverse effects; D005240:Feasibility Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D009520:New Zealand; D010352:Patient Dropouts; D010710:Phosphates / Q000097:blood*; D011446:Prospective Studies; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002614:Chelating Agents; D008078:Cholesterol, LDL; D010710:Phosphates; D003084:Colestipol; D002118:Calcium
keywords: haemodialysis; phosphate; phosphate binder