Impacto do uso dos quelantes do fósforo, acetato de cálcio e hidrocloreto de sevelamer, sobre os níveis séricos de paratormônio e FGF-23 de pacientes portadores de doença renal crônica / Impact of the use of phosphate binders, calcium acetate or sevelamer hydrochloride, on serum parathormone and FGF-23 levels of chronic kidney disease patients

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

INTRODUCTION: Parathyroid hormone (PTH) and fibroblast growth factor (FGF-23) levels increase early in CKD before the occurrence of hyperphosphatemia. This study evaluated the effect of two phosphate binders, calcium carbonate or sevelamer hydrocloride, on PTH and FGF-23 levels in patients with CKD. METHODS: Forty two patients were randomized in two groups to receive calcium acetate or sevelamer hydrochloride, over a 6-wk period. After that, the patients were followed by more two weeks and effects of phosphate binders on mineral parameters were analyzed. RESULTS: At baseline, patients presented with elevated fractional excretion of phosphate, serum PTH and FGF-23 During treatment with both phosphate binders, there was a progressive decline in serum PTH and urinary phosphate, but no change in serum calcium or serum phosphate. Significant changes were observed for FGF-23 only in sevelamer-treated patients. CONCLUSIONS: This study confirms the positive effects of early prescription of phosphate binders on PTH control. Prospective and long-term studies are necessary to confirm the effects of sevelamer hydrocloride on serum FGF-23 and the benefits of this decrease on outcomes

ASSUNTO(S)

hormônio paratireóideo fator de crescimento de fibroblasto 23 phosphorus insuficiência renal crônica parathyroid hormone fibroblast growth factor 23 fósforo renal insufficiency chronic

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