10. Erfurter Experten-Meeting Dialyse – Phosphat-Binder-Therapie:
Kalziumfrei bietet zahlreiche Vorteile

Die Phosphatkontrolle ist eine wichtige Säule in der Therapie von chronisch nierenkranken Patienten. Die verschiedenen Phosphat-Binder-Klassen haben jedoch unterschiedliche Nebenwirkungs- und Risikoprofile. Im Rahmen einer Pro-Contra-Diskussion auf dem 10. Erfurter Experten-Meeting Dialyse am 23.06.2012 wurde deutlich, dass das nicht resorbierbare, kalzium- und metallfreie Sevelamer mit geringen Risiken einhergeht und außerdem aktiv die Gefäße schützt.

• Literatur

• 1 Block GA, Klassen PS, Lazarus JM et al. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol 2004; 15: 2008-2018
• 2 Zoccali C, Ruggenenti P, Perna A et al. Phosphate may promote CKD progression and attenuate renoprotective effect of ACE inhibition. J Am Soc Nephrol 2011; 22: 1923-1930
• 3 Chertow GM, Burke SK, Raggi P. Treat to Goal Working Group. Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients. Kidney Int 2002; 62: 245-252
• 4 Asmus HG, Braun J, Krause R et al. Two year comparison of sevelamer and calcium carbonate effects on cardiovascular calcification and bone density. Nephrol Dial Transplant 2005; 20: 1653-1661
• 5 Block GA, Spiegel DM, Ehrlich J et al. Effects of sevelamer and calcium on coronary artery calcification in patients new to hemodialysis. Kidney Int 2005; 68: 1815-1824
• 6 Di Iorio B, Bellasi A, Russo D. INDEPENDENT Study Investigators. Mortality in kidney disease patients treated with phosphate binders: a randomized study. Clin J Am Soc Nephrol 2012; 7: 487-493
• 7 Block GA, Raggi P, Bellasi A et al. Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients. Kidney Int 2007; 71: 438-441
• 8 Suki WN, Zabaneh R, Cangiano JL et al. Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients. Kidney Int 2007 2007; 72: 1130-1137
• 9 Bommer J, Ketteler M, Ritz E. Impact of oral calcium on mortality of dialysis patients--an underestimated risk?. Nephrol Dial Transplant 2012; 27: 2628-2633
• 10 Caglar K, Yilmaz MI, Saglam M et al. Short-term treatment with sevelamer increases serum fetuin-a concentration and improves endothelial dysfunction in chronic kidney disease stage 4 patients. Clin J Am Soc Nephrol 2008; 3: 61-68
• 11 Gutierrez OM, Mannstadt M, Isakova T et al. Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. N Engl J Med 2008; 359: 584-592
• 12 Yilmaz MI, Sommez A, Saglam M et al. Comparison of calcium acetate and sevelamer on vascular function and fibroblast growth factor 23 in CKD patients: a randomized clinical trial. Am J Kidney Dis 2012; 59: 177-185