Long-term effects of sevelamer hydrochloride on the calcium x phosphate product and lipid profile of haemodialysis patients

Nephrol Dial Transplant. 1999 Dec;14(12):2907-14. doi: 10.1093/ndt/14.12.2907.


Background: Short-term studies have suggested that sevelamer hydrochloride, a non-aluminium- and non-calcium-containing hydrogel, is an effective phosphate binder in haemodialysis patients, and may produce favourable changes in the lipid profile.

Methods: To determine the long-term effectiveness of sevelamer hydrochloride, we performed an open-label clinical trial in 192 adult patients with end-stage renal disease on haemodialysis. Drug-related changes in the concentrations of serum phosphorus, calcium, calcium x phosphate product, parathyroid hormone, and low- and high-density lipoprotein cholesterol concentrations were the major outcomes of interest.

Results: Treatment with sevelamer was associated with a mean change in serum phosphorus of -0.71+/-0.77 mmol/l, serum calcium of 0. 08+/-0.22 mmol/l, and calcium x phosphate product of -1.46+/-1.78 mmol/l (P<0.0001 for all comparisons). There were no significant overall treatment-related changes in parathyroid hormone. Serum levels of LDL cholesterol decreased by 0.81+/-0.75 mmol/l (mean -30%, P<0.0001) and HDL cholesterol increased by a mean of 0.15+/-0.29 mmol/l (mean +18%, P<0.0001). Drug-related adverse events were infrequent and most were of mild intensity.

Conclusion: Sevelamer is a safe and effective phosphate binder that leads to significant improvements in the calcium x phosphate product and lipid profile of haemodialysis patients.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Calcium / metabolism*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parathyroid Hormone / blood
  • Phosphates / metabolism*
  • Phosphorus / blood
  • Polyamines / therapeutic use*
  • Renal Dialysis*


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Parathyroid Hormone
  • Phosphates
  • Polyamines
  • Phosphorus
  • polyallylamine
  • Calcium