Comparative Efficacy of Sevelamer Hydrochloride Versus Calcium Acetate on Bone Biomarkers in patients with End Stage Renal Disease on Hemodialys

ABSTRACT Aim: To compare the effects of Sevelamer and calcium acetate on biomarkers of bone turnover in patients of end stage renal disease (ESRD). Methods: This was a prospective, randomized, open label study, total 140 patients of ESRD underwent two week washout period and were divided randomly into two groups, Group A (received Sevelamer) and Group B (received calcium acetate) for 24 weeks. Mean changes in the serum level of calcium phosphorus and intact PTH were measured and compared. Results: After 24 weeks of treatment there was significantly reductionof phosphorus in Group A as compared with Group B (-1.764mg/dl vs.1.0600 p=0.000). Mean change in iPTH was more in Group B as compared with Group A (-124.32pg/ml vs. –83.44 pg/ml, p=0.044). There is significant increase in serum calcium level in Group B patients compared to Group A (0.688mg/dl vs. –0.126 mg/dl, p=0.000). Conclusion: Sevelamer effectively reduces serum phosphorus with a lower incidence of rise in serum calcium level in dialysis population, although more reduction of iPTH occurred in calcium acetate group. Key words: Savelmer hydrochloride, bone biomarkers, renal disease, hemodialysis