Meta-Analysis Of Maintenance Hemodialysis Patients With Vascular Calcification Treated With Sevelamer And Traditional Phosphorus Binder

Objective:Systematic analysis of the efficacy and safety of sevelamer and traditional phosphorus binders in maintenance hemodialysis patients with vascular calcification。Methods:Through the Nanchang University Library’s official website,PubMed,The Cochrane Library,Embase,Wanfang,CNKI and other databases published publicly at home and abroad.clinical studies on vascular calcification with sevelamer and traditional phosphorus binders were screened,literature that meets the requirements,evaluated,Valid data from articles were collected and analysed using the RevMan 5.3software.Results:Through screening and analysis,a total of 12 RCT(1427 cases)were included.Compared to traditional phosphorus binders,patients with sevelamer had lower blood calcium levels(WMD =-0.33,95% CI-0.43--0.24)and higher iPTH levels(WMD= 101.61,95% CI For 32.60~107.61),the total cholesterol level was lower(WMD =-26.71,95% CI-41.19~-12.22),and the LDL level was lower(WMD =-18.77,95%CI-29.40~-8.13),The CRP level is lower(WMD=-0.14,95% CI is-0.21~-0.07),Coronary artery calcification scores and large arterial calcification scores were low(WMD equals-60.59,95% CI-95.87~-25.30),(WMD equals-997.31,95% CI-1643.95~-350.68),and gastrointestinal adverse reactions occur.The rate was high(RR=2.24,95% CI 1.32 to 3.81),and the hospitalization rate was low(RR=0.62,95%CI 0.39 to 0.98).Conclusious:Compared with traditional phosphorus binders,sevelamer reduced the vascular calcification and the hospitalization rate through improving the abnormal calcium and phosphorus metabolism,dyslipedimia,and reducing chronic in flammation in ERSD patients with maintenance hemodialysis.