Objective: To review phosphate-binder choice and mortality in hemodialysis patients.
Data sources: A literature search was performed using the PUBMED database to identify clinical trials published from January 1966 through January 2009. Search terms included: sevelamer and mortality, calcium acetate and mortality, and calcium carbonate and mortality.
Study selection: Clinical trials relating the effect of phosphate-binder choice on cardiovascular disease and mortality in hemodialysis patients, judged to be pertinent by the authors, were selected for discussion. DATA SYNTHESIS/CONCLUSIONS: The Renagel in New Dialysis (RIND) extension study and the Dialysis Clinical Outcomes Revisted (DCOR) study were the first clinical trials to compare the effects of calcium-based phosphate binders and sevelamer hydrochloride on mortality in hemodialysis patients. Based on the results of these and other studies evaluated, it is still unclear if sevelamer hydrochloride has a survival benefit in hemodialysis patients over calcium-based phosphate binders.