Association of a phosphorus counting table with sevelamer hydrochloride for control of hyperphosphatemia in hemodialysis patients

• Grant number: 14/22367-6
• Support Opportunities: Regular Research Grants
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: José Abrão Cardeal da Costa
• Grantee: José Abrão Cardeal da Costa
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

The hyperphosphatemia is common in hemodialysis patients and it is important in the development of bone mineral disease. It contributes to soft tissue calcification, raising the risk of cardiovascular diseases and mortality. Removal by dialysis, reduction of the intestinal absorption through phosphate binder and intake reduction of phosphorus are the main therapeutic strategies for the control of hyperphosphatemia. The aim of this study will be evaluate the effect of association of a phosphorus counting table (PCT) with sevelamer hydrochloride (SH) for control of hyperphosphatemia. We will follow 78 patients, who will be randomized in control (CG) and intervention groups (IG). The CG will have biochemical parameters, dietetic data, nutritional status (NS) and dose of phosphorus binder observed for 4 months. The IG will have 2 months in observation period, and the same parameters observed in the CG will be analyzed. After this phase the patients will be randomized in IG A that will be oriented to do a diet control by using PCT associated with a reduced and fixed dose of SH for 2 months and, in IG B that will be applied the association of the PCT with a self-adjust dose of SH for 2 months too. In the two periods of application of PCT and SH will be analyzed monthly biochemical parameters (phosphorous, total and ionic calcium), dietetic data, dose of SH, and at the beginning and at the end of each period will be applied the evaluation of the NS and blood level of parathyroid hormone (PTH), fibroblast growth factor 23 (FGF-23), 25-hydroxyvitamin D, alkaline phosphatase, total cholesterol, albumin, urea, creatinine and transferrin. At the end of the study, all collected data will be compared between CG and IG. (AU)