Sevelamer suspension in children with end-stage renal disease.

Control of hyperphosphatemia is a major clinical challenge in children with end-stage renal disease. The best treatment option is a calcium-based phosphate binder, but there is evidence that this treatment protocol causes long-term complications, including vascular calcification. Sevelamer hydrochloride has been shown to be effective in reducing serum phosphorus levels and the calcium-phosphorus ion product in children on maintenance dialysis and may be key in preventing soft-tissue and vascular calcifications in such patients. Until the U.S. Food and Drug Administration approves the use of sevelamer hydrochloride in children undergoing dialysis and a liquid dosage form becomes available, compounding pharmacists will need to prepare this unique compound for these patients.