Effect of sevelamer hydrochloride on markers of bone turnover in Japanese dialysis patients with low biointact PTH levels
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概要
- 論文の詳細を見る
Background: In hemodialysis patients, adynamic bone disease has been reported to be closely associated with low levels of parathyroid hormone (PTH) due to exposure to high levels of serum calcium following the administration of calcium carbonate (CaCO3) or vitamin D agents. This study was conducted to clarify the therapeutic effect of a non-calcemic phosphate binder, sevelamer hydrochloride (sevelamer), for hypoparathyroidism in hemodialysis patients with or without diabetes mellitus. Methods: Based on entry criteria, 40 Japanese chronic hemodialysis patients (22 males and 18 females with a mean age of 60.6, 14 diabetic patients and 26 non-diabetic patients) were switched from CaCO3 to sevelamer for 48 weeks. Serum calcium, phosphate, intact (i) PTH and PTH-(1-84) were analyzed. Bone remodeling activity was evaluated by determining intact osteocalcine (iOC), bone-specific alkaline phosphatase (BAP). Results: The switch from CaCO3 to sevelamer significantly decreased the serum levels of calcium, resulting in the elevation of iPTH levels from 31±18 pg/mL to 95±96 pg/mL by 48 weeks. In contrast, serum phosphate levels remained similar to those in patients with CaCO3 treatment. Concomitantly, the levels of BAP and iOC were elevated. Further, these beneficial effects on bone turnover were observed in both diabetic and non-diabetic patients. Conclusion: Sevelamer reduced the calcium concentration and thereby increased PTH levels, resulting in the improvement of markers of bone turnover. The administration of sevelamer is of therapeutic benefit for the improvement of bone remodeling activity even in hemodialysis patients with diabetes. © 2007 The Japanese Society of Internal Medicine.
- 日本内科学会の論文
著者
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YOKOYAMA Hitoshi
Department of Gastroenterology and Nephrology, Kanazawa University Graduate School of Medical Scienc
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Wada Takashi
金沢大学 医学部血液浄化療法部
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Iwata Yasunori
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Wada Takashi
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Toyama Tadashi
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Kitajima Shinji
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Okumura Toshiya
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Hara Akinori
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Yamahana Junya
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Nakaya Izaya
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Kobayashi Motoo
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Kitagawa Kiyoki
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Kokubo Satoshi
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Yoshimoto Keiichi
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Shimizu Kazuaki
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Sakai Norihiko
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Furuichi Kengo
Division of Blood Purification, Kanazawa University Hospital
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Koshino Yoshitaka
The Kanazawa Study Group for Renal Diseases and Hypertension
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Takaeda Chikako
The Kanazawa Study Group for Renal Diseases and Hypertension
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Takeda Shinichi
The Kanazawa Study Group for Renal Diseases and Hypertension
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Takasawa Kazuya
The Kanazawa Study Group for Renal Diseases and Hypertension
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Ohta Satoshi
The Kanazawa Study Group for Renal Diseases and Hypertension
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Takaeda Masayoshi
The Kanazawa Study Group for Renal Diseases and Hypertension
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Kaneko Shuichi
Disease Control and Homeostasis, Kanazawa University Graduate School of Medicine
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Toyama Tadashi
富山県立中央病院 内科
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Nakaya Izaya
富山県立中央病院 内科
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Yokoyama Hitoshi
Department Of Cardiovascular Surgery Faculty Of Medicine Fukushima Medical University
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Furuichi Kengo
Division Of Blood Purification Department Of Gastroenterology And Nephrology Graduate School Of Medi
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Kaneko Shuichi
Disease Control And Homeostasis Graduate School Of Medical Science Kanazawa University
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