| [ Summary ] |
Arterial disease in hemodialysis (HD) patients is characterized by medial calcification and is associated with increased mortality. Of importance, arterial calcification increases with prescribed dose of calcium-based phosphate-binder. In fact, calcium-based phosphate binders, such as calcium carbonate, are associated with progressive coronary artery and aortic calcification, especially when mineral metabolism is not well controlled. In contrast, sevelamer, a non-calcium-based phosphate binder, arrested the progression of valvular and vascular calcification in almost 50% of HD subjects. The difference is explained by increased level of serum Ca after ingestion of calcium-based phosphate binder, since serum Ca X phosphate product regulates the occurrence of metastatic calcification. |