Comparative analysis of the use of phosphate-binding drugs in patients receiving hemodialysis

Introduction. Chronic kidney disease (CKD) is a widespread, non-communicable chronic condition that leads to a significant deterioration in quality of life and high mortality among patients. Hyperphosphatemia is an independent factor in increasing all-cause and cardiovascular mortality at all stages of CKD.

Aim. To comparatively evaluate the efficacy of calcium-free phosphate binders (sevelamer carbonate and beta-iron(III) oxyhydroxide complex of sucrose and starch) in patients receiving hemodialysis.

Materials and methods. A retrospective analysis of 94 medical records of patients with end-stage CKD receiving renal replacement therapy was conducted. Inclusion criteria: Patients aged 18 to 85 years with end-stage CKD, undergoing hemodialysis for 12 months and receiving phosphate binders.

Results. In the total group of patients (94 people), statistically significant changes in phosphorus levels were observed over the course of the year-long observation period (p = 0.001). In the first group of patients taking beta-iron (III) sucrose oxyhydroxide starch complex, a statistically significant decrease in phosphorus levels over time (p = 0.046) (Friedman test used). In the second group of patients receiving sevelamer carbonate, a statistically significant change was also observed (p < 0.001) (Friedman test used). When assessing the additional effects of phosphate binders, statistically significant changes were found across the two study drug groups: increased blood albumin levels (p < 0.001) and increased transferrin levels (p < 0.001). Statistically significant changes in cholesterol reduction were found in the sevelamer carbonate group (p = 0.044). The Friedman test was used in the assessments. No statistically significant changes were found in C-reactive protein or ferritin levels in the two study groups.

Conclusion. Our studies of the effectiveness of phosphate-binding therapy showed that in both groups there were positive changes in the normalization of phosphorus levels in the blood throughout the entire period and were statistically significant in both comparison groups.

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