@article{oai:kanazawa-u.repo.nii.ac.jp:00031016,
 author = {Iwata, Yasunori and Wada, Takashi and Yokoyama, Hitoshi and Toyama, Tadashi and Kitajima, Shinji and Okumura, Toshiya and Hara, Akinori and Yamahana, Junya and Nakaya, Izaya and Kobayashi, Motoo and Kitagawa, Kiyoki and Kokubo, Satoshi and Yoshimoto, Keiichi and Shimizu, Kazuaki and Sakai, Norihiko and Furuichi, Kengo and Koshino, Yoshitaka and Takaeda, Chikako and Takeda, Shinichi and Takasawa, Kazuya and Ohta, Satoshi and Takaeda, Masayoshi and Kaneko, Shuichi},
 issue = {8},
 journal = {Internal Medicine},
 month = {Apr},
 note = {Background: In hemodialysis patients, adynamic bone disease has been reported to be closely associated with low levels of parathyroid hormone (PTH) due to exposure to high levels of serum calcium following the administration of calcium carbonate (CaCO3) or vitamin D agents. This study was conducted to clarify the therapeutic effect of a non-calcemic phosphate binder, sevelamer hydrochloride (sevelamer), for hypoparathyroidism in hemodialysis patients with or without diabetes mellitus. Methods: Based on entry criteria, 40 Japanese chronic hemodialysis patients (22 males and 18 females with a mean age of 60.6, 14 diabetic patients and 26 non-diabetic patients) were switched from CaCO3 to sevelamer for 48 weeks. Serum calcium, phosphate, intact (i) PTH and PTH-(1-84) were analyzed. Bone remodeling activity was evaluated by determining intact osteocalcine (iOC), bone-specific alkaline phosphatase (BAP). Results: The switch from CaCO3 to sevelamer significantly decreased the serum levels of calcium, resulting in the elevation of iPTH levels from 31±18 pg/mL to 95±96 pg/mL by 48 weeks. In contrast, serum phosphate levels remained similar to those in patients with CaCO3 treatment. Concomitantly, the levels of BAP and iOC were elevated. Further, these beneficial effects on bone turnover were observed in both diabetic and non-diabetic patients. Conclusion: Sevelamer reduced the calcium concentration and thereby increased PTH levels, resulting in the improvement of markers of bone turnover. The administration of sevelamer is of therapeutic benefit for the improvement of bone remodeling activity even in hemodialysis patients with diabetes. © 2007 The Japanese Society of Internal Medicine., 金沢大学保健管理センター, 金沢大学大学院医学系研究科, 金沢大学附属病院},
 pages = {447--452},
 title = {Effect of sevelamer hydrochloride on markers of bone turnover in Japanese dialysis patients with low biointact PTH levels},
 volume = {46},
 year = {2007}
}