Meta analysis of efficiency and safety of sevelamer in the treatment of hyperphosphatemia in patients with maintenance hemodialysis

Objective The objective of this review is to inquire the efficiency and safety of sevelamer to decrease the level of serum phosphate of the patients with maintenance hemodialysis.Methods According to the strict inclusion and exclusion criteria we search the China knowledge network, wanfang database and weipu database and pubmed in subject heading by using the search terms of sevelamer, dialysis. We selected the randomized controlled trails that meet the criteria. Collecting all the information of the selected studies on the methodology and using the information to synthesis and analysis, and finally evaluaing the efficiency and safety of sevelamer to decrease the level of serum phosphate of the patients of maintenance dialysis.Results ①We identified 9 reports meeting the inclusion criteria for our review. In those studies, 1 715 patients were included, experimental group contains 872 patients and control group contains 843 patients. All those studies using sevelamer to decrease the level of serum phosphate of the patients of maintenance dialysis. Meta analysis of serum phosphate showed that MD=-0.18,95%CI(-0.37,0.01),P<0.05,means that sevelamer is more effective than calcium preparation on decreaing the level of serum phosphate, the differerce is significant. ②2 reports recorded the adverse reaction, Meta analysis of adverse reaction showed that OR_combination=1.04,95%CI(0.03,35.06),P>0.05, the occurrence of adverse reaction between taking sevelamer and taking calcium preparation is similar and has no significant differernce. ③We identified 8 reports meeting the inclusion criteria that taking serum calcium as an indicator. In those studies, 1 625 patients were included, experimental group contains 827 patients and control group contains 798 patients. Meta analysis of serum calcium showed that MD=-0.00,95%CI(-0.20,0.21),P<0.05, means that taking sevelamer has less influence on serum calcium than taking calcium preparation.Conclusions Taking sevelamer on hyperphosphatemia patients of maintenance dialysis is more effective than calcium preparation on decreasing the level of serum phosphate. And has no difference on the adverse reaction and has less influence on serum calcium. Because of low quality and quantity of the included studies. The argumentation intensity of this Meta analysis may be influenced.