title: Cardiovascular mortality in chronic kidney disease patients: potential mechanisms and possibilities of inhibition by resin-based phosphate binders.
abstract: Cardiovascular mortality has been considered as the most important risk associated with chronic kidney disease. The mechanisms underlying this include inflammation, poor control of serum phosphate, high serum calcium, increased calcification of the arteries and cardiac valves, hyperlipidemia, diabetes, severe anemia, uric acid accumulation and others. Elevated phosphate levels have been strongly associated with increased mortality, thus phosphate-binding drugs have long been used to control the increase serum phosphate levels. However, phosphate-binding drugs differ considerably and recently numerous publications suggest differences between agents in the effects on overall mortality. The resin-based phosphate binders, comprising sevelamer and colestilan, not only reduce serum phosphate but also do not raise serum calcium. In addition, they reduce serum LDL-C, inflammation, uric acid and high Hba1c values. These differences suggest that not all phosphate binders may be equal in the context of cardiovascular mortality in this patient population.
authors: Department of Nephrology, Alessandro Manzoni Hospital, Lecco, Italy.
authors: Francesco
authors: F
authors: Locatelli
authors: Lucia
authors: L
authors: Del Vecchio
mesh_terms: D000818:Animals; D001647:Bile Acids and Salts / Q000494:pharmacology / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D002614:Chelating Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D010710:Phosphates / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D000069603:Sevelamer / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D001647:Bile Acids and Salts; D002614:Chelating Agents; D010710:Phosphates; D000069603:Sevelamer; D002118:Calcium; C106574:cholebine
keywords: cardiovascular mortality; chronic kidney disease; colestilan; hyperlipidemia; hyperphosphatemia; phosphate binders; sevelamer