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Sevelamer hydrochloride: a calciumand metal-free phosphate binder

Anthony J Bleyer and James Balwit

Sevelamer hydrochloride is a nonabsorbed, calcium- and metal-free phosphate binder, used to bind phosphate and prevent phosphate accumulation in patients with kidney failure. Sevelamer hydrochloride has been an important alternative to calcium-based phosphate binders, because calcium-based binders result in increased gastrointestinal calcium absorption and a positive calcium burden in dialysis patients. Recent studies have shown that sevelamer hydrochloride slows the progression of cardiovascular calcification when compared with calcium-based binders – such decreases in cardiovascular calcification may potentially lead to a reduction in morbidity and mortality in dialysis patients.