The impact of improved phosphorus control: use of sevelamer hydrochloride in patients with chronic renal failure

Phosphorus control is a primary goal in the care of patients with end-stage renal disease (ESRD). Sevelamer hydrochloride, a novel calcium-free, aluminum-free phosphate binder, allows physicians to control serum phosphorus in patients with ESRD without increasing serum calcium levels or contributing an excess calcium load. Clinical studies have shown that sevelamer provides sustained reduction in markers of soft-tissue and cardiac calcification, specifically serum phosphorus, calciumxphosphorus product, parathyroid hormone and also improves blood lipid profiles. Thus, sevelamer hydrochloride offers the promise of impacting cardiac calcification and thereby reducing patient morbidity and mortality. Long-term studies are underway to evaluate these potential benefits. This paper reviews sevelamer studies to date and addresses ongoing strategies for improving clinical management of phosphorus in ESRD.