Effects of sevelamer hydrochloride on mortality, lipid abnormality and arterial stiffness in hemodialyzed patients: a propensity-matched observational study
| Autor: | Soichiro Iimori, Tomokazu Okado, Yusuke Tsukamoto, Junichi Ishigami, Tamaki Kuyama, Wataru Akita, Tsuyoshi Ohnishi, Michio Kuwahara, Satomi Shikuma, Shigeru Takada, Tomoki Asai, Yoshihiro Mori, Sei Sasaki, Masato Tajima |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Physiology medicine.medical_treatment Sevelamer Kaplan-Meier Estimate Pulse Wave Analysis Severity of Illness Index Gastroenterology Calcium Carbonate Cohort Studies chemistry.chemical_compound Vascular Stiffness Renal Dialysis Physiology (medical) Internal medicine Severity of illness Polyamines medicine Humans Ankle Brachial Index Renal Insufficiency Chronic Survival rate Dialysis Aged Chelating Agents Cholesterol business.industry Cholesterol HDL Cholesterol LDL Middle Aged Lipid Metabolism medicine.disease Surgery Survival Rate chemistry Arterial stiffness Female business Follow-Up Studies Kidney disease medicine.drug |
| Zdroj: | Clinical and Experimental Nephrology. 16:930-937 |
| ISSN: | 1437-7799 1342-1751 |
| DOI: | 10.1007/s10157-012-0640-4 |
| Popis: | Cause-and-effect associations between sevelamer hydrochloride (HCl) and mortality have yet to be clarified. The effects of sevelamer HCl on mortality, lipid abnormality and arterial stiffness were examined in patients with chronic kidney disease stage 5D.The effects of sevelamer HCl were studied by a single-center cohort study that was conducted from January 1, 2005 to December 31, 2008 (n = 483). By the end of the study, 172 patients (Sevelamer group) had succeeded in continuing sevelamer HCl for6 months (median 37 months), and 300 patients (Control group) had received calcium carbonate (n = 264) or no phosphate binder (n = 36). The mortality and other outcomes were compared between these two groups after matching by a propensity score calculated using age, gender, diabetes prevalence, and dialysis vintage.All-cause [hazard ratio (HR) 0.4, P = 0.02] and cardiovascular (CV)-cause [HR 0.29, P = 0.03] cumulative mortality were significantly lower in the matched Sevelamer group than in the matched Control group. The matched Sevelamer group showed increased high-density lipoprotein cholesterol (P = 0.003) and no change in pulse wave velocity (PWV) and ankle-brachial index (ABI), whereas the matched Control group showed increased serum low-density lipoprotein (LDL) cholesterol (P = 0.003), increased PWV (P = 0.03), and decreased ABI (P = 0.0009). Change in serum LDL cholesterol level correlated inversely with sevelamer HCl dosage (P = 0.02).Reduced mortality in patients with sevelamer HCl may, at least in part, be explained by an improvement in dyslipidemia and arterial stiffness by sevelamer HCl. |
| Databáze: | OpenAIRE |
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