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Brand names: Renvela / Renagel • Drug class: Phosphate binder (non-calcium)
Sevelamer is a non-calcium phosphate binder — the modern standard for controlling phosphorus in dialysis and advanced CKD. Unlike calcium-based binders, it doesn't add to the calcium load, which matters for vascular calcification risk.
Phosphorus control in CKD-MBD is about binding dietary phosphorus in the gut. Sevelamer binds phosphate without calcium — preferred when calcium runs high (KDIGO: limit calcium-based binders). It also lowers LDL cholesterol as a side benefit. Must be taken WITH meals to work; it's not absorbed systemically.
KDIGO 2017: restrict calcium-based binders when calcium is elevated or calcification present — non-calcium binders like sevelamer preferred
KDIGO CKD-MBD guideline, 2017
Sevelamer lowers LDL cholesterol alongside phosphorus
Pivotal trials, 2002
Renvela (sevelamer carbonate): start 800 mg (2 tablets) 3×/day with meals; titrate by phosphorus. Renagel (hydrochloride) similar. Take with every meal — the #1 adherence failure is taking binders between meals.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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