2025/09/16 by Nandakumar, B M, Hiremath, Bharati V, Rahul, N
#Chronic/drug therapy #Ileitis/etiology #Renal Insufficiency #Sevelamer/adverse effects
paper · doi:10.71749/pkj.99
The prevalence of chronic kidney disease (CKD) has surged globally over the past two decades. Sevelamer, a non‑calcium phosphate binder, has gained popularity due to its relatively good safety profile for treating hyperphosphatemia in CKD patients. However, recent reports have identified a novel side effect of sevelamer: deposition in the gastrointestinal (GI) mucosa, leading to injury. Symptoms range from nonspecific abdominal discomfort to severe complications such as ulceration and gangrene. Demonstration of characteristic sevelamer crystals in biopsies is diagnostic. To date, 40 reports of sevelamer‑induced GI complications exist in the literature. An elderly male suffering from end‑stage renal disease presented with sub‑acute intestinal obstruction. He failed to respond to initial conservative measures and upon exploration was found to have necrotising ileitis due to sevelamer‑induced inflammation with mass formation. In CKD patients presenting with abdominal pain, clinicians should maintain a high index of suspicion for Sevelamer‑induced intestinal injury.