A Study on Hyperphosphatemia and Effect of Sevelamer on Cardiac Enzyme Levels in Chronic Kidney Disease Patients

Objective: Chronic Kidney Disease (CKD) is characterized by progressive loss of kidney function over a period of time. Sevelamer hydrochloride is a phosphate binding agent used to control serum phosphate levels in End Stage Renal Disease (ESRD) patients with hyperphosphatemia. Since hyperphosphatemia is associated with acute myocyte injury and elevation of cardiac biomarkers. ESRD patients treated with sevelamer hydrochloride display reduced cardiac biomarker levels due to a decrease in serum phosphate. Therefore, the study was designed to evaluate the effect of sevelamer hydrochloride on cardiac enzyme levels. Methods: This retrospective observational study was carried out in the nephrology department of a multispecialty hospital for a period of two months. Clinical and biochemistry reports of 30 ESRD patients were collected in designed case report forms. All statistical analysis was carried out using International Business Machines-Statistical Package for the Social Sciences, version 17 (IBM SPSS 17) Statistics package. Results: No significant difference in cardiac enzymes between sevelamer-treated and untreated groups was observed. Hence, further prospective studies on sevelamer hydrochloride are necessary to determine their activity in preventing hyperphosphatemia-induced acute myocyte injury. Conclusion: A direct correlation was observed between cardiac enzyme markers and phosphate levels. However, sevelamer at conventional doses was not found to be effective in reducing acute cardiomyocytes injury caused by hyperphosphatemia. Hence, higher doses sevelamer or other modalities achieving normal serum phosphorous levels are necessary for preventing cardiac damage due to hyperphosphatemia in ESRD patients.