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https://www.readbyqxmd.com/read/28584909/a-review-of-phosphate-binders-in-chronic-kidney-disease-incremental-progress-or-just-higher-costs
#1
REVIEW
Wendy L St Peter, Lori D Wazny, Eric Weinhandl, Katie E Cardone, Joanna Q Hudson
As kidney disease progresses, phosphorus retention also increases, and phosphate binders are used to treat hyperphosphatemia. Clinicians prescribe phosphate binders thinking that reducing total body burden of phosphorus may decrease risks of mineral and bone disorder, fractures, cardiovascular disease, progression of kidney disease, and mortality. Recent meta-analyses suggest that sevelamer use results in lower mortality than use of calcium-containing phosphate binders. However, studies included in meta-analyses show significant heterogeneity, and exclusion or inclusion of specific studies alters results...
June 5, 2017: Drugs
https://www.readbyqxmd.com/read/28577730/-sucroferric-oxyhydroxide-a-novel-iron-based-phosphate-binder-which-current-use-in-dialysis-patients
#2
Pierre Bataille, Vincent Delattre, Maité Daroux
International guidelines suggest lowering elevated phosphorus level to the normal range in patients on dialysis. Among the phosphate-lowering strategies, phosphate binder is frequently used in addition to dietary phosphate restriction and an adequate dialysis strategy. However, serum phosphate concentration higher than 1.78mmol/L is observed in more than 40% of patients justifying the quest for new drugs. Sucroferric oxyhydroxide is one of the new iron-based agents and is available in France since May 2016...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28525528/sevelamer-versus-calcium-based-phosphate-binders-for-chronic-kidney-disease
#3
Gonzalo A Bravo-Soto, Trinidad Madrid
Chronic kidney disease-mineral and bone disorder is prevalent. There is controversy regarding whether calcium-based phosphate binders or sevelamer - a non-calcium phosphate binder – constitute a better therapeutic alternative. Searching in Epistemonikos database, which is maintained by screening multiple information sources, we identified 12 systematic reviews comprising 61 studies of which 41 correspond to randomized trials addressing the question of this article. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
May 12, 2017: Medwave
https://www.readbyqxmd.com/read/28464802/phosphate-binders-affect-vitamin-k-concentration-by-undesired-binding-an-in-vitro-study
#4
A Neradova, S P Schumacher, I Hubeek, P Lux, L J Schurgers, M G Vervloet
BACKGROUND: Vascular calcification is a major contributing factor to mortality in end stage renal disease (ESRD). Despite the efficacy of phosphate binders to improve hyperphosphatemia, data on vascular calcification are less clear. There seems to be a difference in attenuation or delay in progression between different binders. In this in vitro experiment we tested whether phosphate binders could limit bioavailability of vitamin K2 by undesired binding. Vitamin K-deficiency limits activation of the vascular tissue mineralization inhibitor matrix γ-carboxyglutamate (Gla) protein (MGP) thereby exacerbating vascular calcification...
May 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28445401/tradeoff-in-the-nephron-a-theory-to-explain-the-primacy-of-phosphate-in-the-pathogenesis-of-secondary-hyperparathyroidism
#5
Kenneth R Phelps
Chronic kidney disease (CKD) causes secondary hyperparathyroidism (SHPT). The cardinal features of SHPT are persistence of normocalcemia as CKD progresses and dependence of the parathyroid hormone concentration ([PTH]) on phosphate influx (IP). The tradeoff-in-the-nephron hypothesis integrates these features. It states that as the glomerular filtration rate (GFR) falls, the phosphate concentration ([P]CDN) rises in the cortical distal nephron, the calcium concentration ([Ca]CDN) in that segment falls, and [PTH] rises to maintain normal calcium reabsorption per volume of filtrate (TRCa/GFR)...
April 26, 2017: Nutrients
https://www.readbyqxmd.com/read/28429551/the-role-of-calcium-and-non-calcium-based-phosphate-binders-in-chronic-kidney-disease
#6
Grahame J Elder, Jacqueline Center
Rising levels of serum phosphate occur late in the course of chronic kidney disease (CKD) and have been easy targets for nephrologists to treat using phosphate binding drugs, as well as fertile ground for the pharmaceutical industry, for meta-analysis and for the earnest pontifications of guideline writers. Unfortunately, the evidence does little to support this focus, which might be better applied to earlier, adaptive hormonal changes, and to phosphate balance rather than serum phosphate levels. Nevertheless, phosphate binders are ubiquitously prescribed to patients on dialysis, and often prescribed to patients with earlier stages of CKD; for which there is no evidence of benefit and some evidence that calcium-based binders (CBBs) and possibly non-CBBs may cause more harm than placebo...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28339993/one-year-efficacy-and-safety-of-the-iron-based-phosphate-binder-sucroferric-oxyhydroxide-in-patients-on-peritoneal-dialysis
#7
Jürgen Floege, Adrian C Covic, Markus Ketteler, Johannes Mann, Anjay Rastogi, Bruce Spinowitz, Viatcheslav Rakov, Laura J Lisk, Stuart M Sprague
Background.: Sucroferric oxyhydroxide is a noncalcium, iron-based phosphate binder that demonstrated sustained serum phosphorus control, good tolerability and lower pill burden compared with sevelamer carbonate (sevelamer) in a Phase 3 study conducted in dialysis patients. This subanalysis examines the efficacy and tolerability of sucroferric oxyhydroxide and sevelamer in the peritoneal dialysis (PD) patient population. Methods.: The initial study (NCT01324128) and its extension (NCT01464190) were multicenter, Phase 3, open-label, randomized (2:1), active-controlled trials comparing sucroferric oxyhydroxide (1...
February 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28291581/a-real-world-cost-effectiveness-analysis-of-sevelamer-versus-calcium-acetate-in-korean-dialysis-patients
#8
Jang-Hee Cho, Hye Min Jang, Hee-Yeon Jung, Ji-Young Choi, Sun-Hee Park, Chan-Duck Kim, Chul Woo Yang, Dong-Chan Jin, Yong-Lim Kim
PURPOSE: Sevelamer, a noncalcium phosphate binder, has been shown to attenuate the progression of vascular calcification and improve survival in patients with chronic kidney disease undergoing dialysis compared with calcium-based binders. Using real-world data from a cohort study and the Health Insurance Review and Assessment Service database, we conducted a cost-effectiveness analysis comparing sevelamer with calcium acetate in dialysis patients from the perspective of the National Health Insurance Service in South Korea...
March 10, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28248961/effects-of-different-phosphate-lowering-strategies-in-patients-with-ckd-on-laboratory-outcomes-a-systematic-review-and-nma
#9
Nigar Sekercioglu, Argie Angeliki Veroniki, Lehana Thabane, Jason W Busse, Noori Akhtar-Danesh, Alfonso Iorio, Luciane Cruz Lopes, Gordon H Guyatt
BACKGROUND: Chronic kidney disease-mineral and bone disorder (CKD-MBD), a complication of chronic kidney disease, has been linked to reduced quality and length of life. High serum phosphate levels that result from CKD-MBD require phosphate-lowering agents, also known as phosphate binders. The objective of this systematic review is to compare the effects of available phosphate binders on laboratory outcomes in patients with CKD-MBD. METHODS: Data sources included MEDLINE and EMBASE from January 1996 to April 2016, and the Cochrane Register of Controlled Trials up to April 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28169559/challenges-in-diagnosing-medication-resins-in-surgical-pathology-specimens-a-crystal-clear-review-guide
#10
Raul S Gonzalez, Stephen M Lagana, Oliver Szeto, Christina A Arnold
CONTEXT: -Medication resins, including Kayexalate, sevelamer, and bile acid sequestrants, can be encountered in gastrointestinal tract specimens. Their classic histologic appearances have been well documented, but pathologist recognition of the resins is 75%, patient history is not always available, and atypical morphologic findings are sometimes present. OBJECTIVE: -To offer a succinct overview of resins in the gastrointestinal tract, including typical and atypical appearances, in order to serve as a quick reference guide...
February 7, 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28153426/factors-affecting-gastrointestinal-absorption-of-levothyroxine-a-review
#11
REVIEW
Marko Skelin, Tomo Lucijanić, Daniela Amidžić Klarić, Arnes Rešić, Miro Bakula, Ana-Marija Liberati-Čizmek, Hossein Gharib, Dario Rahelić
PURPOSE: Levothyroxine (LT4) is a drug with a narrow therapeutic index, applied in small amounts (micrograms), which makes interactions in the absorption phase clinically significant. The main aim of this article was to review and present the latest information on factors that affect the gastrointestinal absorption of this drug. METHODS: Relevant data were collected by using the MEDLINE, PubMed, EMBASE, Web of Science, Science Direct, and Scopus databases with the key words levothyroxine and absorption...
February 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28068585/effects-of-phosphate-binders-on-the-gastrointestinal-absorption-of-arsenate-and-of-an-sglt2-inhibitor-drug-on-the-urinary-excretion-of-arsenite-in-mice
#12
Miklós Poór, Balázs Németi, Zoltán Gregus
Arsenate (As(V)) and arsenite (As(III)) are typical sources of acute and chronic arsenic poisoning. Therefore, reducing inner exposure to these arsenicals is a rational objective. Because As(V) mimics phosphate, phosphate binder drugs may decrease the intestinal As(V) absorption. Indeed, lanthanum and aluminium salts and sevelamer removed As(V) from solution in vitro, especially at acidic pH. In mice gavaged with As(V), lanthanum chloride, lanthanum carbonate and aluminium hydroxide given orally also lowered the urinary excretion and tissue levels of As(V) and its metabolites, indicating that they decreased the gastrointestinal As(V) absorption...
January 2017: Environmental Toxicology and Pharmacology
https://www.readbyqxmd.com/read/28064234/effect-of-calcitriol-on-fgf23-level-in-healthy-adults-and-its-dependence-on-phosphate-level
#13
Effrosyni Georgiadou, Helen Marketou, George Trovas, Ismene Dontas, Nikolaos Papaioannou, Konstantinos Makris, Antonios Galanos, Athanasios Papavassiliou
AIM: To evaluate the short-term effects of calcitriol and sevelamer hydrochloride on fibroblast growth factor-23 (FGF23) in humans and to determine whether the effect is direct or indirect through calcitriol-induced increased absorption of phosphorus from the intestine. PATIENTS AND METHODS: A total of 15 healthy individuals were tested at three time points and stages, for 24 h and at 1-week intervals. During each stage, blood samples were taken at three time points (0, 8 and 24 h); baseline stage: under no intervention; second stage, while receiving 0...
January 2, 2017: In Vivo
https://www.readbyqxmd.com/read/27989850/long-standing-diarrhea-associated-with-sevelamer-crystalopathy-in-colonoic-mucosa
#14
Rohan M Modi, Benjamin Swanson, Vijay Duggirala
No abstract text is available yet for this article.
October 27, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27971360/cost-minimisation-analysis-of-sucroferric-oxhydroxide-and-sevelamer-carbonate-in-patients-on-dialysis-with-secondary-hyperparathyroidism-in-six-european-countries
#15
J van Stiphout, P Vrouchou, P G Braunhofer, M Schwenkglenks, T D Szucs, P Blank
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27971354/cost-per-responder-analysis-of-sucrofferric-oxhydroxide-versus-sevelamer-carbonate-in-patients-on-hemodialysis-in-europe
#16
M Connolly, N Kotsopoulos, P Vrouchou, E Dubois, S Walpen
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27965186/impact-of-sevelamer-hydrochloride-on-serum-magnesium-concentrations-in-hemodialysis-patients
#17
Ryota Ikee, Takayuki Toyoyama, Toko Endo, Masataka Tsunoda, Nobuo Hashimoto
Serum Mg levels are elevated in patients with renal insufficiency: harmful effects of hypomagnesemia have been reported in patients receiving hemodialysis (HD). In this cross-sectional study, which included 86 HD patients (male : female = 56:30, age 68 ± 12 years), we examined the clinical factors associated with serum Mg levels, with a focus on sevelamer, a phosphate binder widely used to control the hyperphosphatemia of HD patients. The mean serum Mg concentration among our patients was 2.48 ± 0.37 mg/dL (1...
April 1, 2016: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
https://www.readbyqxmd.com/read/27751671/economic-evaluation-of-sevelamer-versus-calcium-based-binders-in-treating-hyperphosphatemia-among-patients-with-end-stage-renal-disease-in-china
#18
Li Yang, Seng Chuen Tan, Can Chen, Xingzhi Wang, Xinya Li, Xiaoyan Yang
PURPOSE: To conduct a cost-effectiveness analysis study of sevelamer versus calcium-based binders (CBBs) in treating hyperphosphatemia among patients with end-stage renal disease (ESRD) in China. METHODS: A decision-analytic model of a lifetime horizon was used for base case analysis from the payers' perspective. The transition probabilities between different health states were derived from survival analysis. The overall survival of CBBs was derived from the Dialysis Clinical Outcomes Revisited study for up to 44 months and a Weibull regression model was used to extrapolate the overall survival to a lifetime horizon...
October 14, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27651467/the-efficacy-and-safety-of-sevelamer-and-lanthanum-versus-calcium-containing-and-iron-based-binders-in-treating-hyperphosphatemia-in-patients-with-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#19
Steven Habbous, Sebastian Przech, Rey Acedillo, Sisira Sarma, Amit X Garg, Janet Martin
Background.: It remains unclear which phosphate binders should be preferred for hyperphosphatemia management in chronic kidney disease (CKD). Methods.: We performed a systematic review and meta-analysis of randomized trials comparing sevelamer or lanthanum with other phosphate binders in CKD. Results.: Fifty-one trials (8829 patients) were reviewed. Compared with calcium-based binders, all-cause mortality was nonsignificantly lower with sevelamer {risk ratio [RR] 0...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27615161/adherence-rates-to-ferric-citrate-as-compared-to-active-control-in-patients-with-end-stage-kidney-disease-on-dialysis
#20
Diana Jalal, Molly McFadden, Jamie P Dwyer, Kausik Umanath, Erwin Aguilar, Yoram Yagil, Barbara Greco, Mohammed Sika, Julia B Lewis, Tom Greene, Simin Goral
INTRODUCTION: Oral phosphate binders are the main stay of treatment of hyperphosphatemia. Adherence rates to ferric citrate, a recently approved phosphate binder, are unknown. METHODS: We conducted a post-hoc analysis to evaluate whether adherence rates were different for ferric citrate vs. active control in 412 subjects with end stage kidney disease (ESKD) who were randomized to ferric citrate vs. active control (sevelamer carbonate and/or calcium acetate). Adherence was defined as percent of actual number of pills taken to total number of pills prescribed...
April 2017: Hemodialysis International
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