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COMPARISON OF SEVELAMER AND CALCIUM CARBONATE ON ENDOTHELIAL FUNCTION AND INFLAMMATION IN PATIENTS ON PERITONEAL DIALYSIS
Author(s) -
Chennasamudram Sudha P.,
Noor Tanjila,
Vasylyeva Tetyana L.
Publication year - 2013
Publication title -
journal of renal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.381
H-Index - 27
eISSN - 1755-6686
pISSN - 1755-6678
DOI - 10.1111/j.1755-6686.2013.12009.x
Subject(s) - sevelamer , medicine , peritoneal dialysis , phosphate binder , endocrinology , calcium carbonate , calcium , hyperphosphatemia , phosphate , carbonate , gastroenterology , biochemistry , chemistry , metallurgy , materials science , organic chemistry
SUMMARY Background Hyperphosphataemia is a known independent risk factor for cardiovascular mortality. The objective of the study was to compare the effects of two phosphate binders, sevelamer carbonate and calcium carbonate on endothelial function (EF) and inflammation in patients on peritoneal dialysis (PD) with Type 2 diabetes mellitus (T2DM). Methods Fifteen subjects with hyperphosphataemia discontinued all phosphate binders to undergo a two‐week washout and were assigned to sevelamer carbonate or calcium carbonate treatments for eight weeks. After a second two‐week washout period, subjects crossed over to either of the alternate treatments for another eight weeks. At the beginning and end of each treatment, biomarkers of EF, pro‐inflammatory cytokines, serum albumin, calcium, phosphate and lipids were measured. Results Sevelamer carbonate significantly improved lipid profile compared with calcium carbonate. Amongst the EF and pro‐inflammatory biomarkers, sevelamer carbonate decreased serum endothelin‐1, plasminogen activator inhibitor‐1, C‐reactive protein and interleukin‐6. Both phosphate binders were effective in decreasing serum phosphate but sevelamer had a positive effect on EF. Conclusions Treatment with sevelamer carbonate has beneficial effects compared with calcium carbonate in decreasing inflammation and improving EF in patients with T2DM on PD.