Abstract

Objectives: Sevelamer can act as a prebiothic with its pleiotropic effects. The aim of this study was to evaluate the effects of sevelamer on serum uric acid, HbA1c and lipid profile levels and the progression of arterial stiffness.

Materials and Methods: A total of 151 patients undergoing maintenance hemodialysis and using the same phosphorus binders under three years follow-up were enrolled. Patients were divided into two groups according to usage of phosphate binders (PB) as sevelamer based PB (group 1) and calcium based PB (group 2). Biochemical parameters were assessed in three year follow up period. Arterial stiffness determined at the initial and at the end of the 3rd year by aortic pulse wave velocity (PWv).

Results: Mean uric acid levels had significantly decreased in group 1 where remained stable in group 2 in three years follow up period. 22.4% of patients in group 1 showed a reduction more than 2 mg/dL in mean uric acid levels. HbA1c levels were lower in diabetic group 1 than group 2. PWv values were similar in both groups at the inital of the study. However; PWv values of group 1 were lower than group 2 at the 3rd year of the study

Conclusion: Sevelamer improves the cardiovascular risk by pleiotropic effects through lowing uric acid, low density lipoprotein-cholesterol and HbA1c concentrations and avoiding the excess calcium intake. Sevelamer improves the cardiovascular risk profile and prevents the progression of arterial stiffness when compared to calcium based PB in hemodialysis patients.

Keywords: Sevelamer, hemodialysis, uric acid, vasculer stiffness