Sevelamer is taken by patients with CKD and hypercalcemia to lower their calcium. How does it work?
By blocking intestinal absorption of phosphate, which lowers PTH secretion. Sevelamer is a phosphate binder. Calcium acetate is also a phosphate binder.
Secondary hyperparathyroidism is a common cause of hypercalcemia in patients with chronic renal insufficiency.
“Sevelamer is a newer synthetic agent in the therapeutic class of phosphate binders, which includes calcium acetate. Decreasing serum phosphate lowers the feedback stimulation of parathyroid hormone secretion by the parathyroid gland, which is often excessive in chronic renal insufficiency. Normalizing parathyroid levels improves serum calcium levels.” ABFM
Mechanism of Action: Binds intestinal phosphate, lowering serum phosphorus (cationic polymer).–Epocrates.
NB: Sevelamer is also used to treat hyperphosphatemia in dialysis patients.