Introduction and Aims: When concerning phosphate binders, sevelamer has an unique effect as a resine that can act as a prebiothic. Avoiding calcium intake ...
Nephrology Dialysis Transplantation 30 (Supplement 3): iii509–iii522, 2015 doi:10.1093/ndt/gfv193.11
CHRONIC KIDNEY DISEASE. NUTRITION, INFLAMMATION AND OXIDATIVE STRESS SP403
SEVELAMER DECREASES SERUM URIC ACID LEVELS AND IMPROVES ARTERIAL STIFFNESS IN HEMODIALYSIS PATIENTS
Siren Sezer1, Bahar Gurlek Demirci1, Emre Tutal1, Zeynep Bal1, Mehtap Erkmen Uyar1 and Fatma NurhanOzdemir Acar2 1 Baskent University Faculty of Medicine, Department of Nephrology, Ankara, Turkey, 2Baskent University Faculty of Medicine, Department of Nephrology, Istanbul, Turkey Introduction and Aims: When concerning phosphate binders, sevelamer has an unique effect as a resine that can act as a prebiothic. Avoiding calcium intake and through pleiotropic effects, there might be a differential influence of phosphate binders (PB) as sevelamer and calcium based PB in terms of cardiovascular risk profile. The aim of this study was to evaluate the effects of phosphorus binders on serum uric acid, HbA1c and lipid profile levels and the progression of arterial stiffness. Methods: A total of 151 patients (mean age: 53.0 ± 14.4 years; mean duration of dialysis:
9.5 ± 1.2 years) undergoing maintenance hemodialysis and using the same phosphorus binders under three years follow-up were enrolled into the study. Patients were divided into two groups according to usage of phosphate binders (PB) as sevelamer based PB (group 1; n: 99) and calcium based PB (group 2; n.52 ). Biochemical parameters as fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), calcium, phosphorus, bicarbonate, C-reactive protein (CRP), lipid prophile (total cholesterol [C], HDL-C, TGs, LDL-C [low-density lipoprotein C; computed from Friedewald’s formula]), uric acid and urea reduction rate (URR) were assessed from monthly clinical visits in three year follow up period. Arterial stiffness determined at the initial and at the end of the 3rd year by aortic pulse wave velocity (PWV) (Sphygmo-Cor). Results: Serum calcium, phosphorus, parathyroid hormone, CRP and URR levels were similar in two groups. Serum LDL-C levels and PWv values were significantly lower in group 1 (p