Long-Term Management of Sevelamer Hydrochloride-Induced Metabolic Acidosis Aggravation and Hyperkalemia in Hemodialysis Patients

Figures & data

Table 1. Patient characteristics

Patients (n)	20
Male/female (n)	14 / 6
Age (years)	62 (42–88)
HD time (months)	89 (19–250)
Vitamin D treatment
Calcitriol (n)	3
Alphacalcidol (n)	4
Parathyroidectomy (n)	5
Dialysate calcium (mEq/L)
2.5 (n)	7
3.5 (n)	13

Table 2. Averages of the control period (T₀) and the study's four six-month intervals (mean ± SD)

	T0	T6	T12	T18	T24
DHCO3 (mEq/L)	34	36.3 ± 1.8	36.8 ± 1.7	37.3 ± 1.9	38.1 ± 1.8
SHCO3 (mEq/L)	17.5 ± 2,01	20.6 ± 1.7	21.3 ± 2	21.7 ± 1.1	21.7 ± 1.4
K (mEq/L)	5.8 ± 0.6	5.2 ± 0.4	5.5 ± 0.5	5.1 ± 0.5	5.2 ± 0.5
P (mg/dL)	5.3 ± 1	5 ± 0.8	4.6 ± 1.1	4.8 ± 0.9	4.5 ± 1
Ca (mg/dL)	9.0 ± 0.5	8.9 ± 0.7	9.1 ± 0.7	8.8 ± 0.7	8.9 ± 0.7
Ca × P (mg^2/dL^2)	48.8 ± 8.5	45.3 ± 8.4	43.6 ± 10.2	44.7 ± 8.2	42.9 ± 9.04
ALP (u/L)	192.2 ± 51.2	208.2 ± 66.2	206.6 ± 58.6	209.7 ± 93.3	205.1 ± 77.6
iPTH (pg/mL)	275.9 ± 259.1	216.9 ± 219.1	247.9 ± 266.6	264.1 ± 258.3	241.3 ± 244.4
TC (mg/dL)	169.6 ± 34.9	163.0 ± 35.4	160.8 ± 36.5	167.6 ± 47.1	165.1 ± 40.2
TG (mg/dL)	170.6 ± 36.1	168.4 ± 64.8	167.0 ± 87.9	163.0 ± 74.4	158.0 ± 72.0
HDL (mg/dL)	47 ± 11.7	47.4 ± 13.3	49.3 ± 15.0	50.5 ± 14.1	50.1 ± 15.0
LDL (mg/dL)	57.4 ± 26.5	58 ± 24.7	67 ± 32.1	65.8 ± 32.6	65.3 ± 31.7
Kt/V	1.3 ± 0.2	1.2 ± 03	1.3 ± 0.3	1.4 ± 0.2	1.4 ± 0.1
SBP (mmHg)	132.6 ± 20.7	134.6 ± 20.7	138.3 ± 22.7	131.1 ± 18.8	132.3 ± 20.8
DBP (mmHg)	74.6 ± 7.7	75.1 ± 7.5	76.0 ± 8.4	74.3 ± 7.7	70.0 ± 8.6

P significance in comparison with semester means against T₀ initial values.

*p < 0.001.

^†p < 0.01.

^‡p < 0.05.

Figure 1 Dialysate and serum bicarbonate changes (mean ± SD).

Figure 2 Serum potassium changes (mean ± SD).

Figure 3 Serum calcium and phosphate changes (mean ± SD).

Figure 4 Ca × P product changes (mean ± SD).

Figure 5 Serum iPTH changes (mean ± SD).

Figure 6 Sevelamer hydrochloride dose correlation vs. serum bicarbonate levels (mean values for the 24-month follow-up). Serum bicarbonate = 22.4–0.013*sevelamer hydrochloride dose (R = −0.67, p = 0.001).

Figure 7 Serum phosphate correlation vs. serum bicarbonate (mean values for the 24-month follow-up). Serum bicarbonate = 25.4–0.87*serum phosphate (R = -0.66, p=0.001).