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題名 | Benefits of Sevelamer on Markers of Bone Turnover in Taiwanese Hemodialysis Patients= |
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作者 | Lin, Yu-feng; Chen, Yung-ming; Hung, Kuan-yu; Chu, Tzong-shinn; Kan, Wei-chih; Huang, Chih-yuan; Lin, Shuei-liong; Kao, Tze-wah; Huang,Jenq-wen; Chiang, Wen-chih; Yen, Chung-jen; Tsai, Tun-jun; Wu, Kwan-dun; Wu, Ming-shiou; |
期刊 | Journal of the Formosan Medical Association |
出版日期 | 20100900 |
卷期 | 109:9 2010.09[民99.09] |
頁次 | 頁663-672 |
分類號 | 415.816 |
語文 | eng |
關鍵詞 | Bone turnover; Hemodialysis; Hypercalcemia; Hyperphosphatemia; Sevelamer hydrochloride; |
英文摘要 | Background/Purpose Sevelamer hydrochloride is a recently developed phosphate binder, which is a quaternary amine anion exchanger without calcium or aluminum. Sevelamer is effective in controlling hyperphosphatemia without increasing the calcium load in chronic hemodialysis (HD) patients. We investigated whether sevelamer restored bone metabolism in chronic HD patients. Methods An 8-week, prospective, open-label, randomized study was conducted after a 2-week washout period in chronic hyperphosphatemic HD patients. This study compared the effect of sevelamer on markers of bone turnover with that of calcium acetate, as stratified by baseline serum intact parathyroid hormone (iPTH) level. Results There was no difference in the changes of serum phosphorus, calcium-phosphorus product and serum iPTH between the sevelamer and the calcium acetate groups. However, more hypercalcemic events (12%) were documented under calcium acetate treatment. In patients with hypoparathyroidism, calcium acetate treatment decreased serum iPTH at the end of the study, while sevelamer did not. Increased serum alkaline phosphatase levels were found among patients receiving sevelamer treatment compared with those who received calcium acetate treatment. In those patients receiving sevelamer, the serum alkaline phosphatase level was also positively correlated to the sevelamer dosage (r = 0.246, p = 0.013). Conclusion Sevelamer effectively reduces serum phosphorus with a lower incidence of hypercalcemic effects in HD patients. Sevelamer is an effective means of treatment for chronic hyperphosphatemic HD patients, especially those with hypoparathyroidism. |
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