Comparing the Effect of Sevelamer Hydrochloride and Calcium Carbonate on Serum Level of hs-CRP, Soluable CD-14 and Endotoxin in Hemodialysis Patients

Abstract

Today, incidence of end-stage renal disease (ESRD) and renal replacement therapy are increasing especially in developing countries. Hyperphosphatemia in patients under hemodialysis usually treated with phosphate binder medications. Studies have also suggested that inflammation is one of the leading causes of death in ESRD patients. The aim of present study was to evaluate the effect of sevelamer hydrochloride and calcium carbonate on inflammatory markers in hemodialysis patients. Materials and methods: In a clinical trial study, 45 ESRD patients whom under hemodialysis and referred to hemodialysis centers of Tabriz University of Medical Sciences and also indicated to treatment with phosphate binders (serum phosphate level greater than 5 mg/dL) and calcium-phosphorus (Ca x P) product were less than 55 mg2/dL2, were included the study. The patients were randomly allocated in two groups and 24 patients (group A) received sevelamer hydrochloride 800 mg PO 3 times daily with meals and 21 patients (group B) received calcium carbonate 500 mg PO 3 times daily with meals. Both groups were treated two months and changes in inflammatory markers in serum including high-sensitivity C-reactive protein (hs-CRP), soluable CD-14 (sCD14) and endotoxin were studied. Results: At the beginning of the study, there was no significant difference in the level of inflammatory markers between the two groups of the study (P>0.05). After two months of treatment the mean hs-CRP, sCD14 and endotoxin in group A were 6.35 (2.72-22.25) mg/L, 245.82±58.09 ng/ml and 2.25±1.02 EU/mL respectively and in group B were 4.50 (2.07-6.15) mg/L, 233.95±59.19 ng/ml and 2.09±0.88 EU/mL respectively. Also, there were no significant differences in inflammatory markers between group A and group B at the end of study (P=0.061, P=0.502 and P=0.589 respectively).