ObjectiveTo explore the effectiveness and safety of sevelamer carbonate (Renvela) for hyperphosphatemia in patients with end-stage renal disease (ESRD).
MethodsESRD patients undergoing renal replacement therapy with hyperphosphatemia in the East District of Qingdao Municipal Hospital from June to November 2013 were randomly divided into two groups. For eight-week treatment course, the trial group was treated with Renvela (initial dose of 800 mg, tid), and the control group was treated with calcium acetate (initial dose of 667 mg, tid). The dose was adjusted every two weeks to achieve serum phosphorus control. Serum levels of phosphorus, adjusted serum calcium, calcium-phosphorus products, intact parathyroid hormone (iPTH), low density lipoprotein cholesterol (LDL-C) and bicarbonate were recorded. Statistical analysis was conducted using SAS 8.2.
ResultsA total of 68 ESRD patients were included, 34 patients in each group. After 8-week treatment, serum phosphorus and calcium-phosphorus products significantly decreased in both groups (P < 0.05). There was no significant difference between the Renvela group and the calcium acetate group in the achievement rate of serum phosphorus (43.33% vs. 36.67%), the incidence of hypercalcaemic events (6.67% vs. 13.33%), and the change of serum iPTH content (-0.88±10.34 pg/mL vs.-0.76±19.14 pg/mL), with no significant difference. However, the Renvela group showed significant advantages in the change of serum phosphorus content (-0.65±0.26 mmol/L vs.-0.53±0.22 mmol/L), the change of adjusted serum calcium content (0.01±0.05 vs. 0.09±0.06 mmol/L), the change of calcium-phosphorus products (-1.45±0.61 mmol2/L2 vs.-0.97±0.47 mmol2/L2), the change of LDL-C content (-0.46±0.10 mmol/L vs. 0.02±0.12 mmol/L), and the change of serum bicarbonate content (-1.00±0.29 mmol/L vs. 0.01±0.18 mmol/L), with significant differences. There was no significant difference in the incidence of adverse reactions (14.71% vs. 11.76%) between the two groups (P=1.00), and the main adverse reaction was gastrointestinal reaction.
ConclusionRenvela is relatively effective and safe for hyperphosphatemia in ESRD patients.
