A 2009 CADTH rapid review of the clinical effectiveness of sevelamer hydrochloride (HCL) for the treatment of chronic kidney disease (CKD) found that sevelamer HCL appeared to be as effective as calcium-based phosphate binders in the management of hyperphosphatemia in CKD patients on dialysis without inducing hypercalcemia. While there was evidence to suggest that sevelamer HCL may slow down the progression of vascular calcification, there was no evidence on its impact on mortality outcomes, and the evidence on its effectiveness on aortic calcification was inconsistent. The report concluded that the published literature at the time did not appear to support the routine use of sevelamer HCL in patients on dialysis.

This report reviews the clinical and cost-effectiveness of sevelamer (i.e., HCL or carbonate) for use in patients with CKD.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• Appendix 1 Selection of Included Studies
• Appendix 2 Characteristics of Included Studies
• Appendix 3 Summary of Critical Appraisal of Included Study
• Appendix 4 Main Study Findings and Authors’ Conclusions
• Appendix 5 Additional References of Potential Interest

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.