Effect of sevelamer combined with calcitriol on calcium-phosphorus metabolism and inflammatory markers in maintenance hemodialysis patients
XU Lixia
BAI Li
MAO Yufeng
FAN Jiayi
Abstract：Objective To explore the effects of sevelamer carbonate combined with calcitriol on calcium-phosphorus metabolism and inflammatory markers in maintenance hemodialysis(MHD)patients.Methods A total of 60 MHD patients admitted to Chongming Hospital Affiliated to Shanghai Health Medical College from February 2024 to February 2025 were divided into the monotherapy group and the combination group using a simple randomization method,with 30 cases in each group.Both groups received routine hemodialysis.The monotherapy group was orally administered sevelamer carbonate,and the combination group was treated with calcitriol shock therapy in addition.Both groups were treated for 3 months.The changes of calcium-phosphorus metabolism indicators,inflammatory markers,quality of life scores,and the occurrence of adverse reactions of the two groups were compared.Results After three months of treatment,the total clinical effective rate of the combination group(90.00%,27/30)was higher than that of the monotherapy group(66.67%,20/30)(χ2=4.812,P=0.028).Blood calcium,blood phosphorus and total parathyroid hormone levels in the combination group((2.25±0.20)mmol/L,(1.80±0.29)mmol/L,(221.93±49.45)pmol/L,respectively)were lower than those in the monotherapy group((2.37±0.21)mmol/L,(1.97±0.32)mmol/L,(295.60±55.24)pmol/L,respectively)(t=2.266,2.156,5.442,all P<0.05).The levels of high sensitivity C-reactive protein and interleukin-6 in the combination group((6.11±0.82)mg/L,(3.95±0.63)pg/mL,respectively)were both lower than those in the monotherapy group((7.54±0.94)mg/L,(4.69±0.71)pg/mL,respectively)(t=6.279,4.270,both P<0.05).The scores of physical symptoms,fatigue,relationship with others,depression and frustration in the combination group((32.15±6.23)points,(30.32±2.56)points,(35.32±5.76)points,(21.62±3.43)points,(10.58±1.51)points,respectively)were all higher than those in the monotherapy group((27.31±3.82)points,(26.17±2.43)points,(28.17±5.43)points,(18.45±2.56)points,(9.43±1.72)points)(t=3.628,6.440,4.947,4.057,2.752,all P<0.05).The incidence rates of adverse reactions in the combination group and the monotherapy group were 10.00%(3/30)and 13.33%(4/30),respectively,with no statistically significant difference(χ2=0.162,P=0.688).Conclusion Sevelamer carbonate combined with calcitriol can synergistically improve calcium-phospho-rus metabolism disorders in MHD patients,reduce micro-inflammatory responses,enhance the quality of life,and demonstrate good safety.
Keywords：sevelamer carbonatecalcitriolmaintenance hemodialysiscalcium-phosphorus metabolismmicro-in-flammatory response
Publication Date：2025-10-25
Online Publishing Date：2025-11-03(First online date of this platform, not the publication date of the document)
Pages：5( 1211-1215 )