Use of sevelamer in chronic kidney disease: beyond phosphorus control
Nefrologia. 2015;35(2):207-17.
doi: 10.1016/j.nefro.2015.05.022.
Epub 2015 Jun 23.
[Article in
English,
Spanish]
Affiliations
- 1 Servicio de Nefrología. Fundación Jiménez Díaz. Madrid (España).
- 2 Servicio de Nefrología. Fundación Jiménez Díaz. Universidad Autónoma de Madrid. Madrid (España).
- 3 Servicio de Nefrología. Fundación Jiménez Díaz. Universidad Autónoma de Madrid. Madrid (España). Electronic address: egparra@fjd.es.
Abstract
Sevelamer is a non-calcium phosphate binder used in advanced chronic kidney disease (CKD) and in dialysis for hyperphosphataemia control. Several experimental, observational studies and clinical trials have shown that sevelamer has pleiotropic effects, beyond hyperphosphataemia control, including actions on inflammation, oxidative stress, lipid profile and atherogenesis, vascular calcification, endothelial dysfunction and the reduction of several uremic toxins. This is the biological basis for its global effect on cardiovascular morbidity and mortality in patients with chronic kidney disease. This review focuses on these pleiotropic actions of sevelamer and their impact on cardiovascular health, with the experience published after more than ten years of clinical expertise.
Keywords:
Efectos pleiotrópicos; Fósforo; Gut; Inflamación e intestino; Inflammation; Phosphate; Pleiotropic effects; Sevelamer.
Copyright © 2015. Published by Elsevier España, S.L.U.
Publication types
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Anticholesteremic Agents / pharmacology
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Anticholesteremic Agents / therapeutic use
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Bone and Bones / drug effects
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Calcinosis / drug therapy
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Chelating Agents / pharmacology
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Chelating Agents / therapeutic use*
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Endothelium, Vascular / drug effects
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Endotoxins / pharmacokinetics
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Fibroblast Growth Factor-23
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Fibroblast Growth Factors / metabolism
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Glycation End Products, Advanced / metabolism
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Humans
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Inflammation
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Intestinal Absorption / drug effects
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Minerals / metabolism
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Oxidative Stress / drug effects
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Phosphorus / metabolism*
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Renal Insufficiency, Chronic / drug therapy*
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Renal Insufficiency, Chronic / metabolism
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Sevelamer / pharmacology
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Sevelamer / therapeutic use*
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Signal Transduction / drug effects
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Uremia / drug therapy
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Uremia / metabolism
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Vascular Diseases / drug therapy
Substances
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Anticholesteremic Agents
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Chelating Agents
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Endotoxins
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Glycation End Products, Advanced
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Minerals
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Phosphorus
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Fibroblast Growth Factors
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Fibroblast Growth Factor-23
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Sevelamer