[Treatment of hyperphosphatemia with sevelamer hydrochloride in CKD patients: effects on vascular calcification and mortality]

Abstract

Hyperphosphatemia with decline of kidney function has been associated with increased mortality and the development of cardiovascular calcification. Sevelamer hydrochloride was the first synthetic non-aluminum and calcium-free phosphate binder commercially available. Sevelamer is as effective as calcium-based binders in lowering phosphate, but without the tendency to promote hypercalcemia. There is some evidence that sevelamer hydrochloride can attenuate cardiovascular calcification compared with calcium-based phosphate binders. Furthermore, sevelamer has several additional pleiotropic effects that may extend its basic indication, some of which may help attenuate vascular calcification. These includes effects on lipid metabolism, and systemic inflammatory response.