Abstract: Objective The purpose of this study was to evaluate the efficacy and safety of Sevelamer hydrochloride in the treatment of maintenance hemodialysis (MHD) patients with hyperphosphatemia. Methods Twenty-four MHD patients treated in the Affiliated Hospital of Guangdong Medical College between July 2013 and July 2014 were enrolled in this study. They were randomly divided into 2 groups according to randomized list. The control group (n=12) received calcium carbonate, while the treatment group (n=12) received Sevelamer hydrochloride for 12 weeks. Efficacy of the treatment was evaluated by changes of serum phosphorus, calcium, calcium-phosphate product, and iPTH. Safety of the treatment was assessed by vital signs and laboratory examination results. Results Twenty-three of the 24 patients completed the study. After Sevelamer hydrochloride treatment for 4 weeks, 8 weeks and 12 weeks, serum phosphorus and calcium- phosphate product decreased significantly (for serum phosphorus, F=6.222 and P=0.001 in treatment group vs. F=3.821 and P =0.016 in control group; for calcium-phosphate product, F=6.222 and P=0.001 in treatment group vs. F= 2.944 and P=0.043 in control group). Serum calcium increased significantly in the control group (F=4.240, P= 0.008), but changed insignificantly in the treatment group (F=1.074, P=0.370). Serum iPTH level changed insignificantly in both groups (F=0.578 and P=0.633 in treatment group vs. F=0.538 and P=0.659 in control group). Vital signs and laboratory indexes had no significant changes in both groups (for ALB, F=0.108 and P=0.955 in treatment group vs. F=0.771 and P=0.517 in control group; for SCr, F=0.105 and P=0.957 in treatment group vs. F=1.111 and P=0.356 in control group; for BUN, F=0.123 and P=0.946 in treatment group vs. F=2.409 and P=0.073 in control group; for HGB, F=0.591 and P = 0.624 in treatment group vs. F=0.518 and P= 0.672 in control group). The common adverse reactions of Sevelamer were gastrointestinal symptoms such as constipation, ventosity and nausea. Conclusion Sevelamer hydrochloride can effectively reduce serum phosphorus and calcium-phosphorus product levels with higher safety. It is therefore worthwhile to be used clinically.

Key words: Chronic renal failure, Hemodialysis, Hyperphosphatemia