{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T21:47:31Z","timestamp":1768513651869,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2005,1,7]],"date-time":"2005-01-07T00:00:00Z","timestamp":1105056000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Gout affects a large fraction of persons with advanced chronic kidney disease, and hyperuricemia may increase the risk of cardiovascular disease. Several hypouricemic agents are contraindicated in patients with end\u2010stage renal disease. Sevelamer is a nonabsorbed hydrogel that binds phosphorus and bile acids in the intestinal tract. Results of short\u2010term and open\u2010label studies suggest that sevelamer might lower the concentration of uric acid, another organic anion. We undertook this study to test our hypothesis that the reduction in serum uric acid concentration induced by sevelamer would be confirmed in a long\u2010term, randomized, clinical trial comparing sevelamer with calcium\u2010based phosphate binders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two hundred subjects undergoing maintenance hemodialysis were randomly assigned to receive either sevelamer or calcium\u2010based phosphorus binders in an international, multicenter, clinical trial. Data on baseline and end\u2010of\u2010study uric acid concentrations were available in 169 subjects (85%); the change in uric acid concentration from baseline to the end of the study was the outcome of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Baseline clinical characteristics, including mean uric acid concentrations, were similar in subjects randomly assigned to receive sevelamer and calcium\u2010based phosphate binders. The mean change in uric acid concentration (from baseline to the end of the study) was significantly larger in sevelamer\u2010treated subjects (\u22120.64 mg\/dl versus \u22120.26 mg\/dl; <jats:italic>P<\/jats:italic> = 0.03). The adjusted mean change in uric acid concentration was more pronounced when the effects of age, sex, diabetes, vintage (time since initiation of dialysis), dialysis dose, and changes in blood urea nitrogen and bicarbonate concentrations were considered (\u22120.72 mg\/dl versus \u22120.15 mg\/dl; <jats:italic>P<\/jats:italic> = 0.001). Twenty\u2010three percent of sevelamer\u2010treated subjects experienced a study\u2010related reduction in the concentration of uric acid equal to \u22121.5 mg\/dl or more, compared with 10% of calcium\u2010treated subjects (<jats:italic>P<\/jats:italic> = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a randomized clinical trial comparing sevelamer and calcium\u2010based phosphate binders, treatment with sevelamer was associated with a significant reduction in serum uric acid concentrations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.20781","type":"journal-article","created":{"date-parts":[[2005,1,7]],"date-time":"2005-01-07T22:40:00Z","timestamp":1105137600000},"page":"290-295","source":"Crossref","is-referenced-by-count":84,"title":["Effects of sevelamer and calcium\u2010based phosphate binders on uric acid concentrations in patients undergoing hemodialysis: A randomized clinical trial"],"prefix":"10.1002","volume":"52","author":[{"given":"Jay P.","family":"Garg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Chasan\u2010Taber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Blair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Plone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juergen","family":"Bommer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Raggi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn 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