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Chronic kidney disease

Epic battles in the phosphate-binder wars—the last episode?

Whether use of non-calcium-containing phosphate binders versus calcium-containing phosphate binders improves outcomes for patients with chronic kidney disease is unclear. Now, new data from an open-label randomized controlled trial suggest that the non-calcium-containing phosphate binder sevelamer hydrochloride significantly improves survival compared to calcium carbonate in incident patients on haemodialysis.

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References

  1. Di Iorio, B. et al. Sevelamer versus calcium carbonate in incident hemodialysis patients: results of an open-label 24-month randomized clinical trial. Am. J. Kidney Dis. http://dx.doi.org/10.1053/j.ajkd.2013.03.023.

  2. Dhingra, R. et al. Relations of serum phosphorus and calcium levels to the incidence of cardiovascular disease in the community. Arch. Intern. Med. 167, 879–885 (2007).

    Article  CAS  Google Scholar 

  3. Ärnlöv, J. et al. Serum FGF23 and risk of cardiovascular events in relation to mineral metabolism and cardiovascular pathology. Clin. J. Am. Soc. Nephrol. 8, 781–786 (2013).

    Article  Google Scholar 

  4. Covic, A. et al. Systematic review of the evidence underlying the association between mineral metabolism disturbances and risk of all-cause mortality, cardiovascular mortality and cardiovascular events in chronic kidney disease. Nephrol. Dial. Transplant. 24, 1506–1523 (2009).

    Article  Google Scholar 

  5. Lynch, K. E., Lynch, R., Curhan, G. C. & Brunelli, S. M. Prescribed dietary phosphate restriction and survival among hemodialysis patients. Clin. J. Am. Soc. Nephrol. 6, 620–629 (2011).

    Article  CAS  Google Scholar 

  6. Cozzolino, M., Rizzo, M. A., Stucchi, A., Cusi, D. & Gallieni, M. Sevelamer for hyperphosphataemia in kidney failure: controversy and perspective. Ther. Adv. Chronic Dis. 3, 59–68 (2012).

    Article  CAS  Google Scholar 

  7. Di Iorio, B., Bellasi, A. & Russo, D. Mortality in kidney disease patients treated with phosphate binders: a randomized study. Clin. J. Am. Soc. Nephrol. 7, 487–493 (2012).

    Article  CAS  Google Scholar 

  8. Block, G. A., Raggi, P., Bellasi, A., Kooienga, L. & Spiegel, D. M. Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney Int. 71, 438–441 (2007).

    Article  CAS  Google Scholar 

  9. St Peter, W. L., Liu, J., Weinhandl, E. & Fan, Q. A comparison of sevelamer and calcium-based phosphate binders on mortality, hospitalization, and morbidity in hemodialysis: a secondary analysis of the Dialysis Clinical Outcomes Revisited (DCOR) randomized trial using claims data. Am. J. Kidney Dis. 51, 445–454 (2008).

    Article  Google Scholar 

  10. Bernard, L., Mendelssohn, D., Dunn, E., Hutchison, C. & Grima, D. T. A modeled economic evaluation of sevelamer for treatment of hyperphosphatemia associated with chronic kidney disease among patients on dialysis in the United Kingdom. J. Med. Econ. 16, 1–9 (2013).

    Article  Google Scholar 

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Covic, A., Voroneanu, L. Epic battles in the phosphate-binder wars—the last episode?. Nat Rev Nephrol 9, 497–498 (2013). https://doi.org/10.1038/nrneph.2013.149

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