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Chronic Acid–Base Perturbations in Hemodialysis Patients Treated with Sevelamer Hydrochloride: A Two‐year Follow‐up Study
Author(s) -
Vlahakos Demetrios V.,
Retsa Kalliopi,
Kalogeropoulou Sofia,
Katsoudas Spiros,
Bacharaki Dimitra,
Agroyannis Basil
Publication year - 2007
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.2007.00484.x
Subject(s) - sevelamer , medicine , metabolic acidosis , calcium , hemodialysis , kidney disease , regimen , phosphate , phosphate binder , endocrinology , gastroenterology , urology , hyperphosphatemia , biochemistry , chemistry
Sevelamer hydrochloride (HCl) contains multiple amines that may cause a significant dietary acid load. To evaluate the impact of sevelamer on arterial blood gases, we followed two groups of stable hemodialysis patients for 24 months. The Sevelamer Group ( n = 7) did not achieve the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) goals for phosporus and Ca × P product and was switched from a calcium‐based to sevelamer‐based regimen. The Calcium Group ( n = 7) achieved those goals and remained on calcium salts. Following sevelamer administration, a deterioration of chronic metabolic acidosis was revealed, which lasted throughout the study. Sevelamer therapy was associated with reduced cholesterol levels, improved serum phosphate, and Ca × P product, which facilitated the management of secondary hyperparathyroidism. No significant changes in acid–base status or other parameter tested were found in the Control Group. In conclusion, sevelamer intake caused small but persistent acid–base disturbances, which did not neutralize sevelamer's beneficial effects on mineral and lipid metabolism.