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Feasibility study of colestipol as an oral phosphate binder in hemodialysis patients
Author(s) -
Hood Christopher J,
Wolley Martin J,
Kam Angela L,
KendrikJones Jamie C,
Marshall Mark R
Publication year - 2015
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12388
Subject(s) - medicine , hemodialysis , phosphate , dentistry , phosphate binder , intensive care medicine , biochemistry , hyperphosphatemia , kidney disease , chemistry
Background Currently available calcium‐ and aluminium‐based phosphate binders are dose limited because of potential toxicity, and newer proprietary phosphate binders are expensive. We examined phosphate‐binding effects of the bile acid sequestrant colestipol, a non‐proprietary drug that is in the same class as sevelamer. Methods The trial was an 8 week prospective feasibility study in stable hemodialysis patients using colestipol as the only phosphate binder, preceded and followed by a washout phase of all other phosphate binders. The primary study endpoint was weekly measurements of serum phosphate. Secondary endpoints were serum calcium, lipids and coagulation status. Analyses used random effects mixed models. Results Thirty patients were screened for participation of which 26 met criteria for treatment. At a mean dose of 8.8 g/24 h of colestipol by study end, serum phosphate dropped from 2.24 to 1.96 mmol/L ( P < 0.001). Three patients required calcium supplementation. LDL cholesterol dropped from 1.75 to 1.2 mmol/L ( P < 0.001). Three patients dropped out because of side effects or intolerance of the required dose. Conclusion The results support the feasibility of a larger trial to determine the efficacy of colestipol as a phosphate binder and that other non‐proprietary anion‐exchange resins may also warrant investigation.