Abstract
Introduction: Hyperlipidemia and hyperuricemia are important complications of renal failure, especially in patients underlying dialysis, therefore, it is important to control these complications with more effective therapies which have lower side effects and costs. Sevelamer is an agent that binds to bile acids and impairs fat absorption and also reduces the absorption of fat-soluble vitamins.
Objectives: In this study, the effect of sevelamer carbonate and sevelamer hydrochloride was investigated on serum levels of cholesterol, triglyceride and uric acid.
Patients and Methods: In a randomized clinical trial, patients undergoing maintenance hemodialysis who were treated with sevelamer carbonate and sevelamer hydrochloride were enrolled in the study and evaluated for complications and outcomes. After one month, cholesterol, triglyceride and uric acid levels were measured. Data were analyzed at a significance level of less than 0.05 using t-test, ANOVA, Mann-Whitney U and the Kruskal-Wallis tests.
Results: In sevelamer hydrochloride group changes in levels of cholesterol, triglyceride and uric acid were 18.80 ± 28.19 mg/dL, 25.52 ± 73.80 mg/dL and 0.85 ± 2.10 mg/dL, respectively. In sevelamer carbonate group, differences for cholesterol, triglyceride and uric acid were 10.17 ±23.66 mg/dL, 3.84 ± 34.57 mg/dL and 0.60 ± 1.59 mg/dL mg/dL, respectively. Sevelamer hydrochloride reduced serum cholesterol (P = 0.321), triglyceride (P = 0.129) and uric acid (P = 0.679) levels more than sevelamer carbonate, however these differences were not significant.
Conclusion: Due to the better clinical effect of sevelamer hydrochloride, it can be recommended in patients with chronic renal failure with overload of phosphorus accompanied by lipid disorders, especially hypercholesterolemia.
Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trial (identifier: IRCT20141016019554N13, https:// en.irct.ir/trial/28916, ethical code; IR.ZUMS.REC.1397.352).