Evels of calcium [8]. Even so, its influence upon cardiovascular calcification, cardiovascular mortality, all-cause mortality and hospitalization just isn’t recognized. A number of evaluations [93] have focused on sevelamer, one of which was carried out in 2010 involving 14 trials and 3271 sufferers [9]. In that meta-analysis, the authors included predialysis sufferers and evaluated the level of cardiovascular calcification applying coronary artery calcification scores (CACS), graded by computed tomography (CT) and representing the progression or regression of coronary artery disease, [14, 15] in four randomized controlled trials (RCTs) in hemodialysis individuals. Jamal et al. (2009) [10] also analyzed cardiovascular calcification by CACS, but identified no substantial variations in CACS amongst patient groups and controls. Three of these reviews [113] deemed biochemical outcomes, and one assessment also evaluated the impact of sevelamer upon all-cause mortality, cardiovascular events, as well as other adverse events [11]. Since then, quite a few trials associated to this situation have already been published. It appears that an updated evaluation from the proof would be of great use to clinicians and decision-makers. Hence, we conducted a meta-analysis of published RCTs on the effectiveness and safety of sevelamer in dialysis individuals.Materials and Methods Information Sources and Literature SearchesWe undertook a systematic meta-analysis of RCTs as outlined by Preferred Reporting Products for Systematic Critiques and Meta-analyses (PRISMA) guidelines (S1 Fig) [16]. We conducted a MEDLINE literature search to recognize all relevant research employing the search terms `sevelamer hydrochloride’, `sevelamer’, or `RenaGel’ from January 1998 to November 2013 and searched PUBMED, EMBASE (`sevelamer hydrochloride’/exp OR `sevelamer hydrochloride’ ORPLOS A single | DOI:ten.1371/journal.pone.0133938 July 31,2 /A Meta-Analysis of Sevelamer on DialysisFig 1.150852-73-6 web Flow diagram of research deemed for inclusion. doi:10.1371/journal.pone.0133938.g`sevelamer’/exp OR sevelamer AND (`renagel’/exp OR renagel) 1811), the specialized register of the Cochrane Renal Group, as well as the Cochrane Central Register of Controlled Trials to identify all RCTs studying the effects of sevelamer hydrochloride using equivalent search terms.NH2-PEG1-CH2CH2-Boc Purity We also searched (manually) the abstracts of conference proceedings of your American Society of Nephrology from 1998 to 2013. However, we did not have access to RCTs that were not reported. Restrictions on language or dates were not imposed in our searches. Ultimately, we found 2961 studies for the analysis. Just after screening, 31 research (on 23 trials) have been included (Fig 1) within the analysis.Study SelectionAll RCTs that studied dialysis ESRD adults (age 18 years) and compared sevelamer to any calcium-based phosphate binder (CBPB) had been included.PMID:23415682 Included research are assumed to possess analyzed the impact of phosphate binders on serum levels of phosphate or calcification of coronary arteries. Studies comparing sevelamer to any other sorts of phosphate binders or no phosphate binders have been excluded. Titles and abstracts were reviewed by two reviewers independently, also as the full-text articles.PLOS One particular | DOI:10.1371/journal.pone.0133938 July 31,three /A Meta-Analysis of Sevelamer on DialysisData Extraction and Quality AssessmentData have been extracted by two authors. A third reviewer checked the extracted information for accuracy. The following data were extracted: country of origin; year of publication; sample size; study design; mean age; percentage of m.