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This is a combination therapy consisting of two phosphate binders, calcium acetate and sevelamer hydrochloride. Both agents are used to control hyperphosphatemia (elevated serum phosphate levels) in patients with chronic kidney disease (CKD), particularly those on dialysis. Calcium acetate acts by binding dietary phosphate in the gut to form insoluble calcium phosphate, which is excreted in the feces, thereby reducing serum phosphorus levels. Sevelamer hydrochloride is a non-absorbed polymer that also binds intestinal phosphate through ionic and hydrogen bonding, preventing its absorption. The combination aims to maximize phosphorus control while minimizing side effects associated with each agent alone—such as hypercalcemia from calcium-based binders or gastrointestinal issues from sevelamer[1][6]. This regimen is primarily indicated for patients with CKD on dialysis who require more effective management of hyperphosphatemia than can be achieved by monotherapy.
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