Nephrol Dial Transplant (2005) 20: 1653–1661 doi:10.1093/ndt/gfh894 Advance Access publication 31 May 2005

Original Article

Two year comparison of sevelamer and calcium carbonate effects on cardiovascular calcification and bone density Hans-Gernot Asmus1, Johan Braun2, Rolfdieter Krause3, Reinhard Brunkhorst4, Herwig Holzer5, Walter Schulz6, Hans-Hellmut Neumayer7, Paolo Raggi8 and Ju¨rgen Bommer9 1

KfH Nierenzentrum Sonnenallee Berlin, Berlin, 2KfH Nierenzentrum Nu¨rnberg, Nu¨rnberg, KfH Nierenzentrum Moabit Berlin, Berlin, 4KfH Nierenzentrum Hannover, Klinikum Hannover Oststadt, Podbielskistrasse 380, D-30659 Hannover, 6Klinikum Bamberg, Bamberg, 7Universita¨tsklinikum Charite´, Berlin, 9 Universita¨tsklinikum Heidelberg, Sektion Nephrologie, Bergheimerstrasse 56a, D-69115 Heidelberg, Germany, 5 Universita¨tskinikum Graz, Graz, Austria and 8Tulane University School of Medicine, New Orleans, LA, USA 3

Abstract Background. Calcium-based phosphate binders may induce tissue calcification, and little is known about their effects on bone density. We compared the effects of a calcium with a non-calcium phosphate binder on both arterial calcification and bone density measured by computed tomography. Methods. Seventy-two adult haemodialysis patients were randomized to treatment with calcium carbonate (CC) or sevelamer (SEV) for 2 years. Electron beam CT scans were performed at baseline and at 6, 12 and 24 months. Serum phosphorus, calcium, calcium
phosphorus product and intact parathyroid hormone (iPTH) were measured and other routine laboratory tests were also carried out. Results. The average calcium
phosphorus product was similar in the two treatment groups. However, patients receiving CC had significantly lower average iPTH (P