Back to Browse Journals » Therapeutics and Clinical Risk Management » Volume 4 » Issue 4

Sevelamer carbonate in the treatment of hyperphosphatemia in patients with chronic kidney disease on hemodialysis

Authors Vincenzo Savica, Domenico Santoro, Paolo Monardo, Agostino Mallamace, Guido Bellinghieri

Published Date September 2008 Volume 2008:4(4) Pages 821—826

DOI http://dx.doi.org/10.2147/TCRM.S3075

Published 1 September 2008

Vincenzo Savica1,2, Domenico Santoro1, Paolo Monardo2, Agostino Mallamace1, Guido Bellinghieri1

1Experimental and Clinic Department of Internal Medicine and Pharmacology, University of Messina, Italy; 2Nephrology and Dialysis Unit, Papardo Hospital, Messina, Italy

Abstract: Sevelamer carbonate is an anion exchange pharmaceutical, developed to improve on the performance of the non-absorbable, non-calcium, and metal-free phosphate binder sevelamer hydrochloride. Sevelamer carbonate is expected not to worsen metabolic acidosis, as previously reported during long-term treatment with sevelamer hydrochloride in hemodialysis (HD) patients. Carbonate is the alternate counterion to chloride on the sevelamer polymeric backbone, but the active poly(allylamine) responsible for phosphate (PO4) binding remains unaltered. Therefore, sevelamer carbonate is expected to reduce elevated serum phosphorus level, similarly to sevelamer hydrochloride. Sevelamers are prescribed in uremic HD patients to control hyperphosphatemia, but the carbonate has also been proposed for the treatment of chronic kidney disease (CKD) non-dialysis patients. Although hyperphosphatemia is regarded as a main contributor to increased mortality in the HD population because of cardiovascular calcification, metabolic acidosis has also been advocated as a major player in the increased mortality in this population, by engendering malnutrition, negative nitrogen balance, and inflammation. This paper reviews the evidence showing that sevelamer carbonate is as good as sevelamer hydrochloride in terms of hyperphosphatemia control in CKD, but with a better outcome in serum bicarbonate balance.

Keywords: chronic kidney disease, sevelamer carbonate, hyperphosphatemia, hemodialysis

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Biocompatibility of Fe3O4@Au composite magnetic nanoparticles in vitro and in vivo

Li Y, Liu J, Zhong Y, Zhang J, Wang Z, Wang L, An Y, Lin M, Gao Z, Zhang D

International Journal of Nanomedicine 2011, 6:2805-2819

Published Date: 9 November 2011

A promising strategy for overcoming MDR in tumor by magnetic iron oxide nanoparticles co-loaded with daunorubicin and 5-bromotetrandrin

Cheng J, Wang J, Chen BA, Xia GH, Cai XH, Liu R, Ren YY, Bao W, Wang XM

International Journal of Nanomedicine 2011, 6:2123-2131

Published Date: 27 September 2011

Evaluation of in-vitro antibiotic susceptibility of different morphological forms of Borrelia burgdorferi

Sapi E, Kaur N, Anyanwu S, Luecke DF, Datar A, Patel S, Rossi M, Stricker RB

Infection and Drug Resistance 2011, 4:97-113

Published Date: 3 May 2011

Changes in CVD risk factors in the activity counseling trial

Meghan Baruth, Sara Wilcox, James F Sallis, et al

International Journal of General Medicine 2011, 4:53-62

Published Date: 19 January 2011

Bioresorbable adhesion barrier for reducing the severity of postoperative cardiac adhesions: Focus on REPEL-CV®

Martin Haensig, Friedrich Wilhelm Mohr, Ardawan Julian Rastan

Medical Devices: Evidence and Research 2011, 4:17-25

Published Date: 12 January 2011

Detection of label-free cancer biomarkers using nickel nanoislands and quartz crystal microbalance

Adrián Martínez-Rivas, Patrick Chinestra, Gilles Favre, et al

International Journal of Nanomedicine 2010, 5:661-668

Published Date: 6 September 2010

Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity

Joseph Finkelstein, Eunme Cha, Steven M Scharf

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:337-349

Published Date: 4 September 2009

Applications of gold nanoparticles in cancer nanotechnology

Weibo Cai, Ting Gao, Hao Hong, Jiangtao Sun

Nanotechnology, Science and Applications 2008, 1:17-32

Published Date: 19 September 2008