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Practical use of sevelamer in chronic kidney disease patients on dialysis in People’s Republic of China

Authors Meng L, Fu B

Received 12 January 2015

Accepted for publication 24 March 2015

Published 30 April 2015 Volume 2015:11 Pages 705—712

DOI https://doi.org/10.2147/TCRM.S64657

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Deyun Wang

Lin Meng,1,2 Bin Fu1

1Department of Nephrology, Second Affiliated Hospital to Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China; 2Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China

Abstract: Hyperphosphatemia is a common complication of dialysis patients. Only 38.5% of Chinese dialysis patients met the Kidney Disease Outcomes Quality Initiative defined targets for serum phosphate. Sevelamer is a high molecular weight cationic hydrogel polymer that prevents absorption of dietary phosphate by binding it in the gastrointestinal tract. In Chinese trials, it was confirmed that sevelamer had better efficacy than calcium carbonate in terms of reducing the serum level of phosphorus and calcium-phosphate product. Sevelamer can also reduce the levels of lipid parameters and improve the micro-inflammatory state. When sevelamer was combined with other treatments, it elicited superior effects on calcium phosphorus metabolism, secondary hyperparathyroidism, and renal osteodystrophy. Combination treatment of sevelamer and traditional Chinese medicine has the unique advantage. However, sevelamer is associated with a high incidence of gastrointestinal adverse effects in Chinese patients. Although more effective, the practical use of sevelamer is not very common because it is expensive and not paid by medical insurance. This article provides a comprehensive review of the practical use of sevelamer in chronic kidney disease patients on dialysis in People’s Republic of China.

Keywords: sevelamer, dialysis, People’s Republic of China, phosphate binders, efficacy, safety

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