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KMID : 0869620140310010614
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 1 p.614 ~ p.624
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Comparative Study of Oral Phosphate Binders for the Management of Hyperphosphatemia in Dialysis Patients
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Park Sun-Hee
Choe In
Choi Eun-Joo
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Abstract
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Hyperphosphatemia, one complication of the end stage renal disease (ESRD), may lead to bone disorders and cardiovascular complications (CVD). The management of hyperphosphatemia treatment needs dietary restrictions and the initiation of oral phosphate binders. Most studies have evaluated the degrees of vascular calcification (VC) by examining the changes in serum calcium levels and also the ability to control serum mineral levels between the calciumbased phosphate binders and non calcium-based ones in dialysis patients. The goal of this study is to compare the clinical results after administering three oral phosphate binders such as calcium acetate, sevelamer hydrochloride, and lanthanum carbonate. We have retrospectively examined 100 out of 222 dialysis patients with electronic medical record (EMR) from 2005 to 2012 based on the inclusion criteria. The EMR data consist of mineral levels, bone and cardiovascular bio-markers from the baseline to 12 weeks. According to our results, all phosphate binders have significantly decreased serum phosphorus levels after 12 weeks (p<0.05). The serum calcium levels associated with VC are not statistically significant differences in each of the three groups (p>0.05). The concentrations of alkaline phosphatase (ALP) associated with bone disorders have increased, although not statistically significant, during the sevelamer and lanthanum treatment.
In the sevelamer treated group, the total cholesterol and low density lipoprotein concentrations
have decreased significantly (p<0.05). Larger and prospective studies associated with the preventions of CVD in dialysis patients are necessary in the future.
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KEYWORD
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Hyperphosphatemia, Oral phosphate binders, Sevelamer, Calcium acetate, Lanthanum
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