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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/26 17:33:19」(JST)

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Sevelamer (rINN) (/sɛˈvɛləmər/ or /sɛˈvɛləmɪər/) is a phosphate binding drug used to treat hyperphosphatemia in patients with chronic kidney disease. When taken with meals, it binds to dietary phosphate and prevents its absorption. Sevelamer was invented and developed by GelTex Pharmaceuticals. Sevelamer is currently marketed by Sanofi under the trade names Renagel (sevelamer hydrochloride) and Renvela (sevelamer carbonate).

Chemistry and pharmacology

Sevelamer consists of polyallylamine that is crosslinked with epichlorohydrin.^[1] The marketed form sevelamer hydrochloride is a partial hydrochloride salt being present as approximately 40% amine hydrochloride and 60% sevelamer base. The amine groups of sevelamer become partially protonated in the intestine and interact with phosphate ions through ionic and hydrogen bonding.

Clinical use

Indications

Sevelamer is indicated for the management of hyperphosphataemia in adult patients with stage 4 and 5 chronic kidney disease on hemodialysis.

Contraindications

Sevelamer therapy is contraindicated in hypophosphataemia or bowel obstruction.

Adverse effects

Common adverse drug reactions (ADRs) associated with the use of sevelamer include: hypotension, hypertension, nausea and vomiting, dyspepsia, diarrhea, flatulence, and/or constipation.

Other effects

Sevelamer can significantly reduce serum uric acid.^[2] This reduction has no known detrimental effect and several beneficial effects, including reducing hyperuricemia, uric acid nephrolithiasis, and gout.

References

^ (1) Rosenbaum, D. P.; Mandeville, W. H.; Pitruzzello, M.; Goldberg, D. I. Nephrology Dialysis Transplantation Effect of RenaGel A , a Non-Absorbable , Cross-Linked , Polymeric Phosphate Binder , on Urinary Phosphorus Excretion in Rats. 1997, 961–964.
^ Garg JP, Chasan-Taber S, Blair A et al. (January 2005). "Effects of sevelamer and calcium-based phosphate binders on uric acid concentrations in patients undergoing hemodialysis: a randomized clinical trial". Arthritis and rheumatism 52 (1): 290–5. doi:10.1002/art.20781. PMID 15641045.

External links

Sevelamer - medlineplus.org
Renagel - genzyme.com
Renvela - genzyme.com

UpToDate Contents

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1. 慢性腎疾患における高リン血症の治療 treatment of hyperphosphatemia in chronic kidney disease
2. 慢性腎臓病における血管石灰化 vascular calcification in chronic kidney disease
3. 小児における、慢性腎臓病に伴う骨ミネラル代謝異常（CKD-MBD） pediatric chronic kidney disease mineral and bone disorder ckd mbd
4. 慢性腎疾患を有する透析前の成人患者における二次性副甲状腺機能亢進症およびミネラル代謝異常のマネージメント management of secondary hyperparathyroidism and mineral metabolism abnormalities in adult predialysis patients with chronic kidney disease
5. 痛風再発の予防 prevention of recurrent gout

English Journal

Comparative effectiveness of calcium acetate and sevelamer on clinical outcomes in elderly hemodialysis patients enrolled in medicare part d.

Yusuf AA1, Weinhandl ED2, St Peter WL3.
American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2014 Jul;64(1):95-103. doi: 10.1053/j.ajkd.2013.11.015. Epub 2013 Dec 31.
BACKGROUND: Phosphate binders are an important therapeutic option for managing hyperphosphatemia in hemodialysis patients. Whether sevelamer confers a survival advantage over calcium acetate is unclear.STUDY DESIGN: Observational cohort study using US Renal Data System (USRDS) data linked to Medicar
PMID 24387795

Efficacy of colestilan in the treatment of hyperphosphataemia in renal disease patients.

Locatelli F1, Dimkovic N, Spasovski G.
Expert opinion on pharmacotherapy.Expert Opin Pharmacother.2014 Jul;15(10):1475-88. doi: 10.1517/14656566.2014.928285.
Introduction: Hyperphosphataemia is common in chronic kidney disease (CKD), particularly in the late stages and is associated with secondary hyperparathyroidism, abnormal bone mineralisation and increased cardiovascular morbidity/mortality. At present, there is a range of phosphate binders designed
PMID 24914480

Effect of chitosan chewing gum on reducing serum phosphorus in hemodialysis patients: a multi-center, randomized, double-blind, placebo-controlled trial.

Akizawa T, Tsuruta Y, Okada Y, Miyauchi Y, Suda A, Kasahara H, Sasaki N, Maeda Y, Suzuki T, Matsui N, Niwayama J, Suzuki T, Hara H, Asano Y, Komemushi S, Fukagawa M.
BMC nephrology.BMC Nephrol.2014 Jun 25;15(1):98. [Epub ahead of print]
BACKGROUND: HS219 (40 mg chitosan-loaded chewing gum) is designed to bind salivary phosphorus as an add-on to available phosphorus binders. We performed a randomized, placebo-controlled, double-blind study to evaluate the efficacy and safety of HS219 in hemodialysis (HD) patients with hyperphosphate
PMID 24968790

Japanese Journal

幼児における塩酸セベラマー使用経験

日本透析医学会雑誌 38(3), 219-225, 2005
NAID 130003875328

Treatment of hyperphosphatemia in hemodialysis patients : The Calcium Acetate Renagel Evaluation (CARE Study)

Kidney Int 65, 1914-1926, 2004
NAID 30014590239

Sevelamer hydrochloride (Renagel( !R)), a non-calcaemic phosphate binder, arrests parathyroid gland hyperplasia in rats with progressive chronic renal insufficiency

Nephrol Dial Transplant 16, 1870-1878, 2001
NAID 30018452153

Related Pictures

Renagel and/or Equivalents Renagel Renagel - patient information, description RENAGEL TABLETS (Sevelamer) dosage Renagel - Renagel Exporter, Distributor RENAGEL Film Tablet 800 mg 180 film Renagel 800 MG. C/180 COMP. funcionamiento-renagel | SigreSigre

★リンクテーブル★

「RENAGEL」

Sevelamer
Systematic (IUPAC) name
	poly(allylamine-; co-N,N'-diallyl-1,3-diamino-2-hydroxypropane)
Clinical data
Trade names	Renagel, Renvela
AHFS/Drugs.com	monograph
MedlinePlus	a601248
Pregnancy; category	B3 (Australia), C (US);
Legal status	Schedule 4 (Australia), Rx only (US);
Routes of; administration	oral
Pharmacokinetic data
Bioavailability	nil
Metabolism	nil
Biological half-life	n/a
Excretion	faecal 100%
Identifiers
CAS Registry Number	52757-95-6
ATC code	V03AE02
PubChem	CID: 3085017
DrugBank	DB00658
ChemSpider	2341997
UNII	941N5DUU5C
KEGG	D08512
ChEMBL	CHEMBL1201492
Chemical data
Formula	[(C3H7N)a+b.(C9H17N2O)c]m; where a+b:c = 9:1
Molecular mass	variable
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関: sevelamer hydrochloride

[1] (1) Rosenbaum, D. P.; Mandeville, W. H.; Pitruzzello, M.; Goldberg, D. I. Nephrology Dialysis Transplantation Effect of RenaGel A , a Non-Absorbable , Cross-Linked , Polymeric Phosphate Binder , on Urinary Phosphorus Excretion in Rats. 1997, 961–964.

[2] Garg JP, Chasan-Taber S, Blair A et al. (January 2005). "Effects of sevelamer and calcium-based phosphate binders on uric acid concentrations in patients undergoing hemodialysis: a randomized clinical trial". Arthritis and rheumatism 52 (1): 290–5. doi:10.1002/art.20781. PMID 15641045.

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案内

案内

Renagel