Evaluation of the Effect of Sevelamer Hydrochloride on Fibroblast Growth Factor-23 Level in Prevalent Hemodialysis Patients

Abstract Background In people with chronic kidney disease (CKD), high levels of FGF23 in the blood which linked to an increased risk of heart problems and death. Phosphate binders to treat CKD patients by lowering their blood phosphate levels, which can also help reduce FGF23 levels. Aim of the Work Evaluation of Sevelamer Hydrochloride effect on FGF23 level in Hemodialysis patients who started hemodialysis sessions more than three months ago. Patients and Methods This study was designed to investigate the potential benefits of sevelamer hydrochloride in hemodialysis patients. It involved 100 participants randomly divided into two equal groups (50 each) using a 1:1 ratio. One group (Group I) received sevelamer hydrochloride treatment. The other group (Group II) did not receive the medication and served as a control group. Results Our study found significant improvements in several key markers in the sevelamer group compared to the group didn’t receive the medications: FGF-23 levels: Decreased significantly by nearly 39.6 pg/ml in the sevelamer group, while in group II showed minimal change (only 0.4 pg/ml) also, showed significantly lower phosphorus (PO4) levels (p-value < 0.001), in addition to parathyroid hormone (PTH) and alkaline phosphatase: Significantly decreased in the sevelamer group compared to group II (p-value < 0.001), and high-sensitivity C-reactive protein (hsCRP): also significantly decreased (p-value < 0.001). Overall, this study suggests that sevelamer treatment may offer potential benefits for hemodialysis patients by: Lowering FGF-23, PO4, PTH, alkaline phosphatase, and hsCRP levels and having minimal side effects. Conclusion Non-calcium-based phosphate binder (Sevelamer hydrochloride) treatment resulted in significant reductions in FGF-23 levels, phosphate levels (PO4), parathyroid hormone levels (PTH), alkaline phosphatase levels, and hsCRP levels suggesting that Sevelamer may be effective in improving the biochemical markers associated with kidney disease, potentially leading to a reduced risk of cardiovascular complications and death.