{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T23:21:09Z","timestamp":1779232869694,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2004,12,22]],"date-time":"2004-12-22T00:00:00Z","timestamp":1103673600000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:title>SUMMARY:<\/jats:title><jats:p><jats:bold>Background:\u2003<\/jats:bold> Poor phosphate control is common among patients with end\u2010stage renal disease. Sevelamer hydrochloride has been demonstrated to be a safe and effective phosphate binder when used as a monotherapy. However, cost limits its usefulness in many countries. Data assessing its effectiveness and safety in combination with conventional phosphate binders are lacking.<\/jats:p><jats:p><jats:bold>Methods:\u2003<\/jats:bold> Dialysis patients meeting the following inclusion criteria participated in this study: (i) hyperphosphataemia &gt;1.8\u2003mmol\/L (5.6\u2003mg\/dL); and (ii) an inability to tolerate currently available binders. The trial was conducted in three phases each lasting 3\u2003months: (i) an observation phase (patients continued on their regular phosphate binders); (ii) a titration phase (sevelamer was added at a dose of 403\u2003mg three times daily with meals, titrated to a maximum of 1209\u2003mg three times daily); and (iii) a maintenance phase.<\/jats:p><jats:p><jats:bold>Results:\u2003<\/jats:bold> Twenty\u2010five patients were recruited into the study. Eighteen patients completed all three trial phases. Mean serum phosphate dropped from 2.11\u2003\u00b1\u20030.06\u2003mmol\/L (6.6\u2003\u00b1\u20030.2\u2003mg\/dL) during the observation period to 1.91\u2003\u00b1\u20030.01\u2003mmol\/L (5.9\u2003\u00b1\u20030.003\u2003mg\/dL) during the maintenance phase (<jats:italic>P\u2003<\/jats:italic>=\u20030.02). Calcium\u2003\u00d7\u2003phosphate product fell from 5.49\u2003\u00b1\u20030.17\u2003mmol<jats:sup>2<\/jats:sup>\/L<jats:sup>2<\/jats:sup> (68.64\u2003\u00b1\u20032.11\u2003mg<jats:sup>2<\/jats:sup>\u2003dL<jats:sup>2<\/jats:sup>) to 4.89\u2003\u00b1\u20030.27\u2003mmol<jats:sup>2<\/jats:sup>\/L<jats:sup>2<\/jats:sup> (61.36\u2003\u00b1\u20033.35\u2003mg<jats:sup>2<\/jats:sup>\u2003dL<jats:sup>2<\/jats:sup>) (<jats:italic>P\u2003=<\/jats:italic>\u20030.02). There was no significant change in serum calcium or parathyroid hormone. Total serum cholesterol fell from 3.8\u2003mmol\/L (3.4\u20134.37) 147\u2003mg\/dL (131\u2013169) to 3.55\u2003mmol\/L (2.97\u20134.2) 137\u2003mg\/dL (115\u2013162) (<jats:italic>P\u2003=<\/jats:italic>\u20030.02). Serum low\u2010density lipoprotein cholesterol also fell significantly from 1.67\u2003\u00b1\u20030.10\u2003mmol\/L (65\u2003\u00b1\u20034\u2003mg\/dL) to 1.52\u2003\u00b1\u20030.11\u2003mmol\/L (59\u2003\u00b1\u20034\u2003mg\/dL) (<jats:italic>P\u2003=<\/jats:italic>\u20030.04). The average prescribed dose of sevelamer was 2.4\u2003g\/day. Elemental calcium dropped from 3.4\u2003g\/day (1.4 to 4.6) to 1.2\u2003g\/day (0.6\u20132.4) (<jats:italic>P\u2003=<\/jats:italic>\u20030.04). Seventy\u2010two per cent of patients reported mild flatulence, nausea and indigestion. Three patients discontinued treatment because of adverse effects.<\/jats:p><jats:p><jats:bold>Conclusions:\u2003<\/jats:bold> Sevelamer in combination with conventional phosphate binders is effective in lowering serum phosphate and calcium\u2010phosphate product in patients with refractory hyperphosphataemia. Beneficial effects on lipid profile were also observed. Mild gastrointestinal upset is common.<\/jats:p>","DOI":"10.1111\/j.1440-1797.2004.00338.x","type":"journal-article","created":{"date-parts":[[2004,12,22]],"date-time":"2004-12-22T10:57:54Z","timestamp":1103713074000},"page":"406-413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Efficacy and side\u2010effect profile of sevelamer hydrochloride used in combination with conventional phosphate binders"],"prefix":"10.1111","volume":"9","author":[{"given":"JOANNA M","family":"STURTEVANT","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"CARMEL M","family":"HAWLEY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KYLIE","family":"REIGER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DAVID W","family":"JOHNSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"SCOTT B","family":"CAMPBELL","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JOHN R","family":"BURKE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANDREW","family":"BOFINGER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NICOLE M","family":"ISBEL","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,12,22]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.1998.v31.pm9531176"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(00)70064-3"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.1998.v32.pm9740172"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200241070-00005"},{"key":"e_1_2_6_6_2","first-page":"381","article-title":"Simultaneous lowering of serum phosphate and LDL\u2010cholesterol by sevelamer hydrochloride (RenaGel) in dialysis patients","volume":"50","author":"Wilkes BM","year":"1998","journal-title":"Clin. 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