The Effect of Phosphate Binders in Patients With End Stage Kidney Disease Undergoing Hemodialysis: a Prospective Cohort Study
Abstract Background: To compare the clinical efficacy of sevalamer carbonate and lanthanum carbonate in chronic hemodialysis patients. Methods: This prospective observational study included 76 patients with follow-up from September 2019 to December 2020. After 15 months of maintenance hemodialysis treatment with sevalamer carbonate or lanthanum carbonate, serum phosphorus, serum calcium, alkaline phosphatase(ALP), parathyroid hormone (iPTH), low-density lipoprotein(LDL), hemoglobin(HGB), triglycerides(TG) and albumin(ALB) were evaluated. The adequacy of dialysis, the effective rate of treatment and the incidence of adverse reactions were compared as well. Results: After treatment, In lanthanum carbonate group, serum phosphorus and iPTH decreased and albumin increased, the difference was significant(P < 0.05). In sevalamer carbonate group, serum phosphorus and LDL decreased and albumin increased after treatment, the difference was significant(P < 0.05). There was no significant difference in the dialysis adequacy and total effective rate between the two groups (P>0.05). However, the incidence of adverse reactions in the sevalamer carbonate group was lower than in the lanthanum carbonate group and the difference was significant (P < 0.05). Conclusion: The two phosphate binders are safe and effective for the treatment of hyperphosphatemia in patients with ESKD undergoing maintenance hemodialysis. Nevertheless, sevalamer carbonate seems to be superior with lowering the incidence of gastrointestinal adverse reactions and improving lipid metabolism.