Does sevelamer have greater skeletal benefit than calcium carbonate in children with secondary hyperparathyroidism?

Tadao Akizawa

This article has no abstract so we have provided the first paragraph of the full text.

SHPT is a serious complication in end-stage renal disease (ESRD) patients on dialysis. SHPT causes severe bone disease, has a considerable role in the development of vascular calcification, and is considered one of the key determinants of ESRD-related mortality and morbidity. To prevent or treat SHPT, correction of hyperphosphatemia and administration of active vitamin D sterols or analogs is essential. Many phosphate binders have been used in this setting. Unfortunately, however, calcium-containing phosphate binders such as calcium carbonate can increase serum calcium levels—particularly when used in combination with active vitamin D sterols. Hypercalcemia is a major risk factor for vascular calcification and adynamic osteodystrophy. Sevelamer, a calcium-free phosphate binder, has been reported to decrease the risk of hypercalcemia in patients receiving vitamin D sterols.¹ In addition, many clinical trials have indicated that combination therapy with active vitamin D sterols and sevelamer effectively suppresses PTH levels in SHPT, although the effect of such treatment on the skeletal lesions of SHPT has not been fully elucidated.

ARTICLE NAVIGATION - ARTICLE TOOLS

• Full text
• Download PDF
• Send to a friend
• PDA services
• Permissions

ISSUE NAVIGATION - THIS ISSUE

• Table of Contents
• Previous article
• Next article