Table 2.
Effects of sevelamer in monotherapy studies
| Study (the level of evidence) [duration] | Drugs/comparators | Patients (n) | Dialysis modality | Main outcomes | Limitations |
|---|---|---|---|---|---|
| Chen et al8 (1B) [8 wks] | Sevelamer carbonate/placebo | 205 | MHD | Hyperphosphatemia developed quickly following the cessation of phosphate binders and remained persistently elevated in end- stage CKD in the placebo-treated group. Gradually titrating up sevelamer carbonate from an initial dose of 2.4 g per day to an average daily dose of 7.1±2.5 g per day was well tolerated, safe, and efficacious. Sevelamer carbonate also decreases LDL and total cholesterol | Short-term |
| Fang et al9 (2A) [14 wks] | Sevelamer hydrochloride | 138 | MHD | Serum phosphorus, Ca-P product significantly decreased, serum calcium and iPTH remained steady, LDL decreased | Short-term; small sample; low evidence level |
| Wang10 (1B) [8 wks] | Sevelamer hydrochloride/calcium carbonate | 55/55 | MHD | Serum phosphorus, Ca-P product, and LDL showed larger decrease in sevelamer group than in calcium carbonate group | Short-term; small sample |
| Tan et al11 (2A) [16 wks] | Sevelamer carbonate | 21 | MHD | Serum phosphorus, Ca-P product significantly decreased, serum calcium and iPTH remained steady | Short-term; small sample; low evidence level |
| Huang12 (1B) [10 wks] | Sevelamer hydrochloride/calcium carbonate | 31/31 | MHD | Serum phosphorus, Ca-P product, and LDL showed larger decrease in sevelamer group than in calcium carbonate group, serum calcium and iPTH showed no statistical difference between two groups | Short-term; small sample; low evidence level |
| He et al13 (1B) [2 wks] | Calcium carbonate/lanthanum carbonate/sevelamer hydrochloride/aluminum hydroxide | 12/13/10/8 | MHD | MHD | Short-term; small sample |
| Lu et al14 (2A) [6 wks] | Sevelamer hydrochloride | 30/20 | MHD | MHD | Short-term; small sample |
| Zhao et al15 (1B) [8 wks] | Calcium carbonate/calcium acetate | 30/30 | HD and PD | HD and PD | Short-term; small sample |
Abbreviations: MHD, maintenance hemodialysis; Ca-P product, calcium-phosphate product; iPTH, intact parathyroid hormone; LDL, low-density lipoprotein; HD, hemodialysis; CKD, chronic kidney disease; wks, weeks; PD, peritoneal dialysis.