Sevelamer carbonate for the treatment of hyperphosphatemia in patients with kidney failure (CKD III - V).

IMPORTANCE OF THE FIELD: Altered mineral metabolism in chronic kidney disease (CKD) is associated with increased morbidity, mortality, hospitalization, cost of care and reduced quality of life. Phosphorus control, one component of CKD metabolic derangements, is potentially related to impaired outcomes and has significant room for improvement. AREAS COVERED IN THIS REVIEW: Historical, present and future aspects of treatment of hyperphosphatemia focusing on sevelamer hydrochloride and sevelamer carbonate. WHAT THE READER WILL GAIN: Comprehensive insight into the background and controversies regarding phosphate binders. TAKE HOME MESSAGE: While calcium-free phosphate binders with a sevelamer backbone may offer therapeutic advantages for CKD patients at risk, more studies comprising significant patient numbers are warranted to answer compelling clinical questions.